This is the third in a series of articles about palliative care.

You've heard that there's a branch of medicine, palliative care, that can help improve your quality of life if you have a serious - often chronic - illness. But what exactly do you ask for?

While there are many forms to help you document your preferences for how to die (among them, Five Wishes at www.agingwithdignity.org/index.php), I found no forms in general use to help people wanting palliative care to note their preferences for how to live. "Living with a Serious Illness" at www.caringinfo.org/files/public/brochures/Living_with_Serious_Illness.pdf provides hints about the emotional and physical roller coaster you might experience. But it focuses more on limitations, not on your priorities for getting the most out of life.

The suggestions below can help you frame a conversation with your doctor.

Start by identifying the three activities that are most important to you that you used to be able to do that you cannot do now because of symptoms of your chronic disease and/or of the treatments you are getting for it. For example, perhaps you love to take long walks, but you have poor balance now. Walking seems too dangerous, so you have given it up.

Perhaps you loved to play Scrabble with your spouse, but you have brain fog so severe that you simply can't figure out how to create many words on the board. Maybe you loved whipping up a pot of your chili that is renowned (at least among your relatives), but you're too tired to buy the ingredients and stand in the kitchen long enough to make it - and you often feel, "Oh, why bother? Who cares?"

Start a list of notes to take to your doctor. First, under the heading "Top Priorities," write down the activities you identified in priority order, and for each one, list the obstacle(s) you are facing. For the examples above, you might write: "poor balance, afraid of falling," "brain fog," and "fatigue and feeling that it's not worth the effort."

Next, identify any other symptoms you have that you think are significantly interfering with your quality of life. Nine common ones for people with serious medical conditions are pain, fatigue, nausea, depression, anxiety, sleepiness and/or insomnia, poor appetite, shortness of breath, and a general sense of malaise (simply not feeling well). Page 4 of the Edmonton Symptom Assessment System at http://www.npcrc.org/files/news/edmonton_symptom_assessment_scale.pdfoffers a chart listing these symptoms. (For sleep issues, though, it focuses on sleepiness rather than on insomnia). It can help you capture on one page on a scale of one to 10 how disruptive any or all of these symptoms are to you.

It can be useful to bring that chart to your doctor. However, it may be even more useful to write down a short explanation of how any given symptom interferes with your quality of life. For example, under a heading of "Other Troublesome Symptoms," you might write something like: "Pain: pain in my right leg makes it hard to walk upstairs, so I just stay in the living room all day even when I'd rather be on my computer upstairs reading the news or emailing friends."

If you are feeling too fatigued or overwhelmed to prepare this information, hand this article to a family member or friend and ask them to help you pull it together. There's a good chance that they have been wishing they could help you, and this is a way that they can do so.

Pulling together this information can help you in at least three ways. First, as suggested above, having this information clearly captured can help your doctor understand why you are interested in getting a referral to a palliative care specialist. Second, when you do meet with a palliative care provider, you won't forget to mention any points that you've concluded are genuinely important to you. Third, preparing this information can help you regain a sense of control that is often one of the first casualties of a serious medical condition.

Next week's column will talk about how to get access to a palliative care provider - you won't find them in the local phone book - and what happens next.