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Part 2: Advance Directives: Easy Ways to Start Hard Conversations

  • Nov 18, 2020
  • Cathy Gasiorowicz
  • 5-min Read

As we discussed in the previous blog ‘Advance Directives: The Gift of A Lifetime,’ having an Advance Directive gives you control over the kind of medical care you want, or want to avoid, in case a serious illness or accident prevented you from speaking for yourself. Once you’ve put your wishes down in writing, it’s important to share them with your healthcare proxy or agent—the person you appoint to make decisions on your behalf if you’re unable to make them yourself—as well as close friends and family.

The best time to share your wishes is before there’s a medical crisis. That’s relatively easy if your family members are comfortable talking about death and dying. Much harder if they’re not. In fact, in some families, the subject of death is as taboo as sex, money, and politics.

If your loved ones fall in the second category, you’re not alone. According to a national survey conducted in 2018 by The Conversation Project, 92% of Americans said it was important to discuss their wishes for end-of-life care, but only 32% had had such a conversation. The reasons for this are as varied as our individual beliefs, values, and family culture. Among those reasons: “I don’t want to tempt fate.” “If I bring this up, my family is going to assume I have cancer.” “It would just upset them.”

Pew Research Center data from 2013 revealed that 52% of survey respondents would “ask their doctors to stop treatment if they had an incurable disease and were totally dependent on someone else for their care.” Another 35% said they would “tell their doctors to do everything possible to keep them alive, even in dire circumstances, such as having a disease with no hope of improvement and experiencing a great deal of pain.” A key takeaway of this research is that individuals respond differently to the same set of circumstances.

 Conversation starters

If your family members change the subject whenever you start talking about your medical or end-of-life wishes, consider using an icebreaker to ease into the conversation. Here are several examples:

“I read this article in the paper recently on ‘peaceful farewells,’ and it got me to thinking about what I would want at the end. I’d really like to talk to you about this.”

 “My coworker, Stan, is having a total hip replacement next week. In addition to having a pre-op exam and rapid COVID test, he had to fill out an Advance Directive—just in case something happens while he’s under anesthesia. I was thinking about I would write and who I’d ask to make decisions for me.” 

 “Do you remember when Aunt Alice got sick? Do you think she lived out the rest of her life according to her wishes? I ask because I want to make sure we know what you would want.”

 “My friend Dawn’s dad passed recently. Those last few months were really hard on her because he couldn’t talk or walk or eat anymore. Have you ever thought about what you would want?”

 “I just answered some questions about what I’d want for medical care if there was no chance of ever being healthy again. I’d like to read you what I wrote. And I’m wondering how you’d answer those questions.”

 “I was thinking about Dick and that terrible bike accident that left him paralyzed. He decided he didn’t want to spend the rest of his life hooked up to a machine. If something like that happened to me and I couldn’t speak for myself, I’d want to die in peace.”

 Find more conversation starters at Honoring Choices® Minnesota.

 Timely opportunities

The holidays are a great opportunity to talk honestly with family members about your medical and end-of-life wishes. Even if you can’t get together in person this year, you can still connect on video—with the added advantage of keeping your loved ones safe. Other family events, such as baptisms, bar mitzvahs, weddings, and (especially) funerals, also offer an opportunity to share your Advance Directive.

Your annual wellness visit is an ideal time to broach this subject. Consider enlisting the help of your primary care doctor or nurse practitioner to facilitate the discussion. Even reticent family members may be more willing to talk about death and dying in the presence of a healthcare professional.

Other conversation starters include the news of a friend’s death, articles about COVID-19 or other illnesses, movies or television shows that address this issue, and sermons or homilies you’ve heard. The idea is to find ways to ease into the conversation so it’s comfortable for you and your loved ones.

Here to support you

Lifespark is passionate about helping you stay in control throughout your life journey. And that includes your wishes for medical and end-of-life care. To connect with Lifespark, schedule a free consultation online, call us at 952-345-0919, or email ShineOn@Lifespark.com.

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