Earlier this year, I wrote a blog about how important it is to prepare for end-of-life decisions you might have to make on behalf of your parents. I wrote about advance directives, and having important conversations with doctors and family.
I culled so much good advice from books and articles that it inspired me to talk to my own family.
Here’s how that went down.
Me to Dad: So, Dad, I’m writing a blog about preparing for end-of-life decisions and it occurred to me that we haven’t really talked about what you and mom want.
Dad: You think we’re DYING!?
(End of conversation)
Me to Sister: So, I’ve figured this all out. I’ll tell Mom and Dad that you should be the financial power of attorney because you’re good with money and I’ll be the healthcare power of attorney because I’m good with healthcare
Sister: * ? *
Me: Oh, see, I was thinking we should get Mom and Dad to focus on creating their advance directives — you know, end-of-life planning
Sister: Is there a book I can read about this?
Me: You know I’m an expert, right? Don’t you trust me?
(End of conversation)
See? THIS is how the experts do it. I should add here that my mother ended up getting a lawyer to create my parents’ “advance directives”. But we aren’t done yet. Because even though creating an advance directive is an important first step in helping others supervise end-of-life healthcare, it isn’t enough. Healthcare decisions are often nuanced and unanticipated Questions and issues are bound to arise. The living will is a guide but it’s not a blueprint. As much as we’d all like to avoid it, there’s simply no replacement for a face-to-face talk.
So this holiday, I’m going to try to talk to my family about this topic, as should you. Because our healthcare system has incredible capabilities to keep people alive way past the point when they realize they are still alive, leaving daughters and sons to agonize over what they think their parents would want.
Talking to your mom and dad about end-of-life can be intimidating, though. Sort of like talking to your teenager about sex. It’s hard and it’s not just one conversation! But, buck up because it’s just as important — and consider keeping the following tips in mind.
Start Small and Use Props
Dr. Angelo E. Volandes, author of The Conversation,, says you don’t have to march up to your parents and ask them how they want to die. You can warm up by starting with positive questions about what they enjoy doing, what they look forward to, what is the best part of their day, etc.
Another way to open the conversation is to use a prop. This can be a news story, a book about end-of-life issues or even a real life situation that you know about. You can say, “Hey Dad — I heard about Mary Jones’ mother and what they went through – can we talk about how to make sure we avoid that situation?”
One great prop I love is The LastingMatters™ Organizer which was created by my friend and colleague, Barbara Bates Sedoric. It’s a beautiful toolkit that helps you and your parents organize, plan for and talk about their intentions. You can find it on the website here, where there’s a Daughterhood discount code to help with the cost.
Use Open-Ended, Non-Threatening Questions
Once you’ve opened up a comfortable dialogue, you can move it along by asking open-ended questions.
In her book about navigating caring for aging parents, Life: The Next Phase, my friend and Tucson Daughterhood Circle Leader, Jodi Hempel and her co-authors, suggest questions such as “What is important to you? What especially worries you?” And to follow those with “What if” scenarios.
At this point, you may be wondering what these questions have to do with whether or not your parent wants a feeding tube. Well, they give you important clues about your parents true values, what they most care about… is it pure time left on the planet or is it the quality of that time — this is what you are trying to suss out.
Document What Your Parent Wants
While you’re having these conversations with your parents, you may want to record them with your phone or at least jot down some notes when you’re done. Even though these aren’t official legal documents, they could end up being an incredibly helpful reference point when you’re in a crisis trying to remember everything.
Follow Up with Medical and Legal
Don’t forget to consult with your parents doctor and lawyer. They’re an important part of this process so make sure they become part of the team. You want to make sure you have your parents wishes in writing and have designated someone to be their healthcare decision-maker. Having your parent talk to a doctor can really help sort out what kinds of decisions they can make now and what those decisions will mean later.
In our society, there’s such a strong tendency to avoid talking about death. It’s makes us uncomfortable. And so we wait until our parents are too sick or too impaired to provide insights into what they’d want. A friend of mine shared with me that her father’s rapid decline occurred before they could discuss his wishes and it thrust her into a shocking and difficult situation. So, her advice and mine is DO IT NOW!
If you want help talking about death or want to bring this topic into the open, I encourage you to look for a Death Cafe in your local area. Death Cafes are groups of people who get together to eat cake, drink tea and discuss death with no objective, agenda or themes. Our amazing San Diego Daughterhood Circle leader, Karen Van Dyke leads the San Diego Death Cafe (also!!) and taught me about this wonderful organization.
Good luck and let me know how it goes!