Families do have the talks but the youngest sister or the grand daughter that lives miles away comes to the bedside and has a conniption fit when she learns that every possible heroic act is not being made to keep granny alive two more weeks.
Just ask the conniption fitter if they want to pay for it. That should do it.
To reiterate and further confirm your comment: A good friend of mine works in a palliative care unit at a large hospital. She said that very often, the “in town” family, who has been there with the patient, knows well the situation, has been talking to the docs and the patient (if there was the opportunity) is on board with the plan to keep the patient comfortable, etc. and not actively pursue any treatment or attempts to prolong life. An ‘out of town’ relative comes in, doesn’t know what has been and perhaps is going on, and totally upsets the apple cart, and as you well stated “has a conniption fit when she/he learns that every possible heroic act is not being made to keep granny alive two more weeks”.
This is not an uncommon occurrence and it’s VERY disruptive and upsetting to the family, perhaps the patient (if still aware, etc.) and also the staff caring for the patient.
that happens to..... this is why having it in writing (as a legal document) sometimes helps. Those who throw those conniption fits are concerned about themselves not the one who is passing from this veil of tears