The conversation no Volusia family wants to have is the one almost every Volusia family eventually wishes they'd had earlier. What does your aging parent want when they're seriously ill, dying, or unable to speak for themselves?
This is a guide to starting that conversation — and to the Florida-specific resources that follow.
Why it's so hard to start
Two reasons. First, talking about death is uncomfortable, and most families avoid it as long as possible. Second, many adult children worry they're "putting ideas in Mom's head" — that bringing up death somehow accelerates it. Neither is true. Research shows that families who have these conversations earlier experience less guilt, less family conflict, and better end-of-life outcomes for the patient.
The hardest part is starting. Once you start, the conversation almost always feels easier than you expected.
Five Wishes — the easiest entry point
Five Wishes is a legal document developed by the Florida-based nonprofit Aging With Dignity. It's been called "the living will with a heart" because it covers not just medical decisions but values, preferences, and emotional wishes.
Five Wishes is legally valid in 46 states, including Florida. It satisfies Florida's healthcare surrogate and living will requirements when properly witnessed. The cost: $5 per copy.
What the five wishes are
- The person I want to make care decisions for me when I can't (your healthcare surrogate)
- The kind of medical treatment I want or don't want (your living will)
- How comfortable I want to be (pain management preferences)
- How I want people to treat me (presence of family, music, religious practices)
- What I want my loved ones to know (final messages, forgiveness, gratitude)
Wishes 1 and 2 are legal in nature; 3, 4, and 5 are personal preference. Together they create one of the most complete portraits of end-of-life wishes available.
How to get the document
- Online: fivewishes.org — print or order paper copies
- Volusia County Council on Aging — keeps copies; ask at any of their locations
- Halifax Health Hospice and AdventHealth Hospice — provide copies free to families they serve
- Most Volusia primary care offices — keep blank copies
How to start the conversation
There's no perfect script. Some openings that have worked:
The "everything's fine" version
"Dad, you're doing great. I'm not worried about anything specific. But I'd love to sit down sometime and just go through what you'd want if something serious happened down the road. Not because I think it's coming — just so we never have to guess."
This framing — "I'm asking now because nothing is wrong, not because something is" — disarms the fear that the conversation itself is a signal.
The "we already do this for ourselves" version
"Mom, I just updated my own living will last month. It got me thinking I don't actually know what you'd want. Could we go over it together sometime?"
Modeling the behavior often opens the door.
The Five Wishes pamphlet
Just bring the pamphlet. Many parents will read it and start talking on their own. "Mom, look at this — it's an easy way to write down what you'd want."
The "after a friend's passing" version
When a family friend has passed and the family handled it poorly (or well), you can use it: "When Bill died, his kids didn't know what he wanted and they fought for months. I don't want that for our family."
What to avoid
- "What do you want when you die?" (too direct, too cold)
- "We need to plan for the worst." (frightening)
- "Have you thought about your funeral?" (premature; funeral comes later)
- Bringing it up at a family gathering with multiple people present (private conversation is better)
What Five Wishes doesn't cover
Five Wishes is excellent for medical and emotional preferences. It doesn't replace:
- A separate Designation of Health Care Surrogate if you want Florida-specific witness verification (Five Wishes does include this, but some Florida hospitals prefer the state-specific form)
- A durable power of attorney for financial decisions (Five Wishes is medical-only)
- A will for asset distribution
- A pre-need funeral plan
- An organ donor designation (handled at FL DMV or DonateLifeFL.org)
A complete advance care planning package usually includes all of the above. An hour with an estate planning attorney pulls it together.
Florida hospice — when it's the right time
A specific note for Florida families: Medicare hospice is one of the most generous benefits in American healthcare. It pays 100% for nurse, aide, social worker, chaplain, medications for the terminal condition, durable medical equipment, and bereavement support for the family.
To qualify:
- The hospice physician (and ideally the primary care physician) certifies that life expectancy is 6 months or less if the disease runs its expected course
- The patient elects hospice in writing
- The election is reversible — if the patient stabilizes, they can return to regular Medicare
Many Volusia families delay hospice because they think hospice means "giving up." It doesn't. Hospice provides intensive, comfort-focused care that often improves quality of life dramatically. The median length of stay in hospice nationally is 17 days — meaning half of patients enroll within 17 days of death, after months of preventable suffering. Don't be in that statistic.
Volusia hospice providers
- Halifax Health Hospice — affiliated with Halifax Health Medical Center; serves Volusia and parts of Flagler
- AdventHealth Hospice Care — affiliated with AdventHealth; serves Volusia and surrounding counties
- VITAS Healthcare — national provider with strong Florida presence
All three offer free information sessions and consultations to families considering hospice.
How TrustWise fits with hospice
Medicare hospice provides skilled clinical care but doesn't staff continuous presence. Many families pair Medicare hospice with non-medical hospice companion support from our caregivers. We:
- Provide in-home companionship during the long quiet hours between hospice visits
- Handle non-medical comfort needs — repositioning, sips of water, light meals when desired, calm presence
- Allow the family to sleep, eat, step away
- Coordinate directly with the hospice nurse, aide, chaplain, and social worker
- Do not duplicate or interfere with hospice clinical care
This is one of the most meaningful services we provide. It is also the one our families are most reluctant to ask about until it's needed.
What to do after the conversation
Once your loved one has expressed their wishes, document them and distribute:
- Sign Five Wishes (or the Florida-specific forms) with required witnesses
- Register at Florida Health Care Advance Directives Registry (free online registry — hospitals can access during emergencies)
- Distribute copies to: primary care doctor, healthcare surrogate, every adult child, the most likely hospital(s), the home care provider
- Carry a wallet card noting the existence of advance directives
- Revisit every 2–3 years — preferences change
Bottom line
End-of-life conversations are hard to start and almost always worthwhile once they begin. Five Wishes makes the conversation structured and approachable. Florida-specific forms add legal weight. Hospice, when the time is right, is one of the most underused benefits in American healthcare.
The kindest thing you can do for your aging parent is to know what they want — and to know it before you have to guess.
If you'd like our complete advance directives checklist as a printable PDF for your family, just call. We'll send it free, whether you're a client or not.
Reviewed by the TrustWise Care clinical team. This article is general guidance. End-of-life planning is personal and should be made in consultation with your loved one, their physician, and a Florida-licensed attorney where appropriate.