VAD: For families

You may feel relief that their suffering will end. You may feel horror that they are choosing this. You may feel both in the same breath. You may feel abandoned, angry, helpless, or numb. None of these are wrong.

VAD is their decision. But the grief is yours, and it does not have to match theirs. They may be at peace. You may be in pieces. That is allowed.

Some families learn early, during the exploration phase. Others are told only after approval. Some find out very close to the day. However you learn, the first reaction is rarely the final one.

• You do not have to respond perfectly. "I need time to take this in" is enough
• Ask what they need from you — they may want support, presence, or simply acceptance
• You can disagree and still be there. Many families hold both
• If you are struggling, a VAD navigator or palliative care social worker can help you process separately

This might be the hardest part. They are sitting up, talking, laughing, eating dinner with you. They look like themselves. And they have chosen a date to die.

With many terminal illnesses, a person can appear well right up until they are not. VAD allows someone to choose to go while they still have dignity, clarity, and the ability to say goodbye on their own terms — rather than waiting until the disease takes those things away.

Your brain will fight this. It will say: "But they're fine. Why now? What if there's more time?" That is a natural response. You are seeing the person you love, not the scans. They are seeing the trajectory.

Some families describe this period as surreal — having normal conversations with someone who has a date circled on the calendar. It is okay to find this unbearable, confusing, heartbreaking, and impossibly tender all at once. You may feel grateful for the goodbye and devastated that you need one.

You do not have to process this alone. Griefline, your GP, or a palliative care social worker can connect you with others who have been through this exact thing.

It is okay to feel that this is wrong. Religious beliefs, moral convictions, fear, love — all of these can make acceptance feel impossible. You are not required to agree.

But the decision is legally and ethically theirs. Trying to prevent it can damage the relationship in the time you have left. Many families find a middle ground: "I do not agree, but I love you and I will be here."

If your faith or beliefs are a barrier, speak to a chaplain or spiritual leader who has experience with end-of-life care. Many have navigated this with other families.

The person will usually know the date in advance. This gives you time — and time can be both a gift and a burden.

• Say what you need to say. Do not assume there will be another chance
• Ask if they want you there on the day — some people do, some do not
• Handle practical things now: who to call, funeral wishes, what they want done with their belongings
• Take photos if it feels right. Record their voice. These become treasures
• Look after yourself. You are allowed to grieve before the death happens

If you choose to be present, you will typically be in a quiet, private space — at home, in a hospice, or in a hospital room. The medical team will be calm, gentle, and experienced. They will explain each step.

The person will usually be peaceful. Many families describe the moment as quiet, dignified, and intimate. It is nothing like what you might fear.

If you choose not to be present, that is also okay. You can say goodbye beforehand in your own way. There is no right answer.

Grief after a VAD death is real, full, and complicated. You may feel relief and sorrow simultaneously. You may feel grateful they did not suffer more and furious that it came to this.

Some people find it hard to talk about because they worry others will judge the decision. You do not have to explain or justify. "They died peacefully, at home" is enough for anyone who does not need to know more.

• The VAD coordinator or navigator may offer follow-up support — take it
• Grief counselling is available through Griefline (1300 845 745) and your GP
• If you are a child of someone who chose VAD, your grief may carry extra layers — a counsellor experienced with end-of-life can help
• StandBy support (1300 727 247) also supports families after VAD deaths

If there are children in the family, they deserve honesty at a level they can understand. "Grandma was very, very sick and the medicine could not fix it. She chose to stop being in pain, and the doctors helped her do that peacefully."

Children will have questions. Answer them simply and truthfully. They may return to the same questions many times — that is normal processing, not distress.

The VAD process includes support for families, but you may need to ask for it. Navigator services, palliative care social workers, and grief counsellors are all available — and they have walked other families through exactly this.