It’s easy and very human to worry about all the “what-if’s” in life. But with aging parents or other loved ones, having an honest conversation about what to do when—not if—health issues become more serious or life threatening can seem downright impossible.
It’s been observed that we Americans are a society that believes death is optional. We put off discussions about how we or loved ones want to be treated when health fails because we don’t want to face the inevitable. But we do ourselves and those we love a disservice by avoiding the subject, especially when medical decisions have to be made.
Better to determine personal preferences in advance—particularly the option not to prolong life—than leave the decision to medical professionals who are committed to saving life. Even with the best of intentions, without a Do Not Resuscitate order in place, for example, a frail 95-year-old who goes into cardiac arrest can end up with a broken ribcage from CPR.
When and How to Have The Talk
How to open up the conversation with your loved one? And when is the right time to broach the sensitive subject of end-of-life choices?
Ideally, it’s best to have The Talk before a crisis hits. Realistically, however, you may not be able to broach the subject until your loved one’s medical condition takes a significant turn for the worse. If you find the conversation too difficult, bring in a trusted family member, close friend, clergy or aging life care professional to help.
A few questions that may help you to explore the sensitive subject of end-of-life choices:
- What is your understanding of your medical status?
- What do you think happens now?
- If you are in pain, how do you want to be cared for?
- What should we do if your heart stops?
- Have you thought about where you want to die?
- Whom do you want to make decisions for you if you are unable?
Push-back is to be expected. Don’t plan on resolving these questions in one or even a few conversations. However, you may also be surprised that your loved one is relieved to discuss choices—even if he or she can’t discuss them with you. Difficult as it may be for you to initiate the conversation, it is often much harder for you loved one, especially a parent, to talk to adult children about death, for fear of upsetting you.
Even if your loved one has dementia, it’s important to at least ask how she or he feels about these questions. You may not get an answer, but you have provided the opportunity. And you may be surprised by your loved one’s verbal or non-verbal responses.
Ultimately, honoring end-of-life choices is all about honoring your loved one’s humanity and right to decide how he or she wishes to die. The clearer you are about that premise, and the more time you take to be sure of your loved one’s true preferences, even if they differ from yours, the more peaceful you will all be when the time comes to act—or not.
For more information about end-of-life decisions, visit Honoring Choices Massachusetts.
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified aging life care manager. Drawing on more than 30 years of professional experience in aging life care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.
For more on coping with aging, follow us on Twitter: @DeborahFinsGCM.