Acting as a surrogate decision maker for a family member with dementia is one of the most difficult aspects of being a caregiver.¹ In this issue, Hanson et al² present the results of a randomized trial testing a decision aid that aims to both improve the quality of communication for goals of care for surrogate decision makers and to increase the delivery of palliative care for residents with advanced dementia. This investigation involved over 300 dyads of long-stay residents with advanced dementia and their family decision makers in 22 diverse nursing homes. The intervention was conducted at the nursing home level; it involved enrolled family decision makers viewing an 18-minute goals of care video decision aid and the nursing staff at that facility receiving a 1-hour training on the aid and principles for family communication. Following the delivery of the goals of care video and staff training, the intervention facilities were prompted to meet with family decision makers. The authors separately report that 69% of structured communications between staff and family occurred within 3 months of family viewing the video.³ Family decision makers and staff in the control arm received an informational video on interactions with people with dementia and a 45-minute training session on the study procedures.