How to Discuss End-of-Life Care with Aging Loved Ones
By Maureen Rulison
Caregiver Support and Resources, LLC
Discussing end-of-life care with aging loved ones is probably one of the hardest conversations life throws at us. People can react so differently to the concept of – gulp – death.
Of course, you’d like to think your folks have their “cards in order” and are prepared for all the medical, financial and legal realities nearing the end. But keep in mind, roughly one-in-three adults actually has a detailed end-of-life care plan. What does that mean? It means well over half of adults don’t, and the likelihood that you and your loved one(s) are not as prepared as you think.
Consider the emotion of it all. It’s easy to understand why end-of-life care decisions are often put on the back burner. Heck, even talking about it feels like something best saved for a better day – a more comfortable setting, less people around, when Cousin Judy is in town, when the finances are in order – or whatever excuses are commonly made.
It’s just uncomfortable. So here are some tips on addressing these topics effectively, honestly and compassionately.
Discussing End-of-Life Care? Let’s Address the Topic with Honesty & Compassion
Some don’t like to discuss their own demise. Others don’t want to upset anyone. Some are just too overwhelmed to begin addressing complicated processes, navigating legal issues, letting others “in” to see poor money management or health realities.
But while these conversations can be difficult and emotional, they’re essential in ensuring that their wishes are respected and that care needs are met.
1. Start the Conversation Early
We ALWAYS recommend early conversations. It’s never too early to begin discussing end-of-life care with your loved ones, whether health difficulties are present now or they’re aging like a fine wine. Sit down now – while everyone is calm, healthy and able to assess rationally – to start at least laying the framework for discussion.
By starting the conversation early, you can avoid making important stressful decisions during end-of-life crisis mode. One of the worst family disputes is whether a loved one would’ve wanted certain medical care while incapacitated. If it’s spelled out early, directly from the care recipient, there can be no argument or ambiguity.
Opening the end-of-life care discussion early is also helpful because there’s SO MUCH to get right. In addition to medical decisions, we also advise discussing financial and legal realities. You don’t want to end up being ineligible for government programs that can cover health care costs or to lose assets because of poorly timed decisions.
2. Be Open & Honest
A care-partner team is useless without strong communication. Encourage the care recipient to express their own wishes and concerns for their end-of-life care. Remember: it’s their life, and they should be the ones in control of their care. Listen carefully to their responses, and respect their right to make their own decisions.
Explain why you feel it’s important to discuss end-of-life care and set goals for the conversation. All parties must speak from a place of caring and support to be able to reach those goals.
3. Ask Specific Questions
Nothing kills a life-care plan like uncertainty. Specific questions yield specific answers.
Ask specific questions about your loved ones’ end-of-life wishes. Potential questions include:
- Which medications and treatments would you want – and not want – in the dying process?
- Do you want a do-not-resuscitate (DNR) order?
- Do you have any religious or cultural beliefs that must be honored?
- Where would you prefer to receive care (home, hospice facility, hospital, etc.)?
- Whom would you like to have power of attorney?
Your loved one may have VERY specific ideas for how their dying days should be spent. (My life partner/care partner, Brian, will have a living memorial service with music, drinks and celebration of life.)
4. Have Sensitivity & Empathy
Death is scary even to the most fearless. The “other side” – however that may be perceived – is uncertain even to the most faithful. And the dying process is rarely quick and painless.
So discussing end-of-life care naturally requires sensitivity and empathy. Your loved one(s) may not know how they would react to certain treatments, or what their physical and emotional state might be when saying goodbye. It’s common to get sad – or even angry – when considering dying days. Unfortunately, these feelings can make people procrastinate or avoid talking altogether.
Remember that these conversations may take time and multiple discussions to come to final decisions. Encourage them to take their time and think about what they want. Honor them with patience and understanding throughout the process.
5. Seek Professional Guidance
A professional life-care planner, like myself, provides valuable support and guidance during these end-of-life discussions and preparations. Not only do we plan to meet needs and wishes, but we also can help the care partner team assess realities they may not have considered. After all, the basis of informed decision making is quality information.
I often facilitate discussions between family members to ensure everyone is on the same page. A neutral and objective perspective also diffuses tension.
Discussing personal wishes with a professional can make sense of difficult decisions, such as whether to pursue life-sustaining treatments. It’s important to consider factors like quality of life when family members cling to emotion over reality as a loved one passes on.
Let’s Discuss End-of-Life Care Plans … Together
Caregiver Support and Resources, LLC helps you honor your aging loved one while planning for end-of-life care. We have over 25 years of experience with all aspects of life-care planning and can help you and your loved one build a plan that honors their wishes.
Of course, you may wish to work with other professionals and spiritual advisors. We’re happy to provide referrals and guide the process in a caring and compassionate way. Feel free to reach out to me at email@example.com with any questions you may have.