How do you bring up end of life decisions?
Pick an appropriate place and time to broach the subject. These are weighty questions, and to do them justice, you'll need an atmosphere that supports reflection and conversation. When you decide the moment is right, be open and direct about it. Aim for frank, honest communication. There are big topics to discuss and possibly loose ends to tie-up such as final wishes, last will and testament, living will, various types of power of attorney designations to name just a few. At the same time, be gentle and don't force anything. Your goal is simply to explore the options.If physical or mental frailty should become an issue, how do they want to spend their last years?
The bestselling book “Being Mortal” explores this question with compassion and depth. “We know how to prolong the life of the body, but we still have little idea how to slow the aging process or prolong the life of the mind,” Gavin Francis summarized in a book review. “Even for those who avoid dementia, the weakness and frailty of extreme old age bring a reliance on others that often requires admission to a nursing home.” Ask your loved ones about their first and second choices for the location and type of care they wish to receive. Also, ask if they have a plan to pay for their long-term care.To what lengths are they willing to go for the chance to live longer?
The second half of the same book takes on the question of “how we can die with grace.” In some situations, medical intervention isn't the best answer, though this may be difficult to accept. As Francis pointed out, “The stunning victories of medical science over the last century have, according to some critics, left too many doctors arrogant and unwilling to concede defeat.”
It's important to ask: At what point in their care would your loved ones prefer to forgo medical interventions? Are there any interventions they know they want to avoid? Most importantly, what does quality of life really mean to them? In recent years, hospice care has emerged as a viable alternative to an older paradigm that prioritizes life at all costs. It can be helpful to get familiar with the hospice care alternatives in your area before you actually require them. Also make sure your loved one's medical power of attorney paperwork is in order.
What do their funeral wishes entail?
Ask your loved ones to envision their funerals for you. How do they wish to be remembered? Do they prefer to be buried or cremated? Where would they like their final resting place to be? What expenses do these wishes entail, and is there a plan to pay for them? Do they have burial insurance and a legal will?
While making end-of-life plans probably won't feel like a party, it is possible that the conversation could bring you closer together. Despite the emotional weight it carries, and no matter how easy it may be to avoid, this is one conversation you don't want to put off.
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