This is the step that many physicians avoid. Although difficult, It is imperative that the healthcare provider listens activity to the patient’s and family’s concerns, Questioning and clarifying what they desire, without the healthcare provider imposing his/her own values and goals. What the nurse is attempting to learn is what this person and his/her family believe they will value as the end of life approaches. Most elders have a strong tendency to favor limitation of treatment when they are unlikely to return to their baseline functioning or are probably dying (Gillick & mender,1996 ) but this is not always true and some elders wish to continue to live until specific events occur or goals are reached. This is the nurse’s opportunity to learn what the elderly and family believe will probably be important as the end of life approaches.