Family meetings for goals of care discussions represent critical communication about serious illness, treatment options, and patient preferences. According to palliative care research, documented goals of care conversations improve care alignment with patient preferences and reduce unwanted intensive care at end of life. Thorough documentation ensures all providers understand patient goals while providing medicolegal protection.
10 Required Elements Checklist
Family Meeting Documentation
| # | Element | Example |
|---|---|---|
| 1 | Date, time, location | "1/15/2026, 3:00 PM, Family Conference Room" |
| 2 | Participants | "Patient, spouse (Jane), son (John), Dr. Smith, SW Jones, RN Williams" |
| 3 | Clinical situation | "Multisystem organ failure, poor prognosis" |
| 4 | Information shared | "Discussed <10% survival, likely severe disability if survives" |
| 5 | Questions asked | "Family asked about timeline and suffering" |
| 6 | Understanding demonstrated | "Daughter stated 'We didn't realize she was dying'" |
| 7 | Patient values identified | "Patient valued being able to recognize family" |
| 8 | Decisions made | "Code status changed to DNR/DNI; transition to comfort care" |
| 9 | Follow-up plan | "Reassess in 48 hours per time-limited trial" |
| 10 | Support offered | "Chaplain, social work, and bereavement resources provided" |
Family Meeting Note Template
**FAMILY MEETING - GOALS OF CARE** **Date/Time:** [Date] at [Time] **Location:** [Room/conference room] **Participants:** - Patient: [Name] [present/unable to participate due to ___] - Family: [Names and relationships] - Medical Team: [Attending, residents, nursing, SW, chaplain] **Clinical Situation:** [Brief summary of current medical status and why meeting was called] **Information Shared:** [What prognosis/options were explained and how] "Explained that patient's [condition] has poor prognosis with [specific estimate]. Even with maximal support, [expected outcomes]. Shared uncertainty about exact timeline but trajectory is [direction]." **Patient/Family Response:** [Questions asked, emotional reactions, understanding demonstrated] "Family appeared to understand. [Direct quote from family member]. Family asked thoughtful questions about [topics]." **Values Exploration:** [What patient would want, in their words or family's understanding] "Patient previously stated [quote or paraphrase]. Family confirmed this is longstanding expressed value." **Treatment Options Discussed:** 1. [Full support option with burdens/benefits] 2. [Limited intervention option] 3. [Comfort-focused option] **Medical Recommendation:** "Team recommends [option] given prognosis and patient's stated values. Final decision rests with patient/family." **Decisions Made:** - Code status: [DNR/DNI / Full code / Specifics] - Treatment plan: [Continue/limit/withdraw specific interventions] - [Direct patient quote if available]: "[Patient's words]" **Follow-Up Plan:** [When to reassess, how to reach team, scheduled meetings] **Support Provided:** [Chaplain, social work, bereavement, family support] [Signature]
Code Status Documentation Language
Sample Phrasing
| Decision | Documentation Language |
|---|---|
| DNR/DNI | "After discussion of likely outcomes, patient/family agreed to DNR/DNI. Patient stated 'I don't want machines keeping me alive if there's no hope.'" |
| Limited code | "Family agreed to attempt CPR but no intubation. If arrest occurs and CPR unsuccessful within 10 minutes, will discontinue efforts." |
| Time-limited trial | "Family requests 48-hour trial of current support. If no improvement, will transition to comfort care. All agreed." |
Documenting Family Disagreement
**When family members disagree:** "Son preferred continuing full support while daughter advocated for comfort care. Facilitated discussion helping family understand each other's concerns. Son expressed guilt about 'giving up.' Explored that comfort care is active care focused on patient's comfort, not abandonment. After extended discussion and medical team guidance, family reached consensus on time-limited trial of 48 hours with reassessment. All family members verbally agreed with this plan."
What to Avoid in Documentation
- Judgmental language: "Family insisted on futile care" → "Family requested continuing support, valuing additional time together"
- Team disagreements: Don't document internal conflicts in family meeting note
- Vague decisions: "Had GOC discussion" → Specify what was decided
- Missing quotes: Include patient/family words when significant
Frequently Asked Questions About Family Meeting Notes
How specific should prognosis discussion be?
Use concrete terms, not euphemisms. "Less than 10% chance of survival" and "patient is dying" are clearer than "very serious condition." Document specific estimates shared. Specificity ensures family understood and guides appropriate care planning.
What if family can't reach consensus?
Document different perspectives and how disagreement was addressed. Note facilitation efforts, ethics consultation if involved, and whatever interim plan was agreed upon. "Unable to reach consensus today; will reconvene tomorrow with ethics consultant."
Should I document emotional reactions?
Yes—emotional context shows the meeting served support function. "Family tearful but expressed understanding and appreciation for honest communication." This documents that information was received and processed, not just delivered.
What about absent family members?
Document communication plan. "Brother in California unable to attend. Will have phone conference this evening. Family authorized sharing information with him." Ensures all decision-makers are informed.
Can AI help with family meeting notes?
Yes, AI tools like River's Family Meeting Note Generator create comprehensive documentation. Input meeting details, and the AI generates structured notes with all required elements, appropriate language, and space for direct quotes. Helps ensure complete documentation during emotionally intense moments.
Quality family meeting documentation honors profound conversations by translating them into clear care plans. Use River's Family Meeting Note Generator to document goals of care discussions completely.