Not THAT talk. If you are middle-aged like me, I’m assuming you’ve had the birds-and-bees talk with your kids by now. I’m speaking about the talk you need to have with your adult children.
For middle-agers, now is the right time to discuss end-of-life wishes with our families. Of course, we want our spouses to know our desires, and this seems to be an easier discussion for most of us to have. Maybe because it turns into a shared discussion: “This is what I want, what do you want?” Plus, your significant other was probably present when you put these decisions on paper in the first place, so they might already know your wishes. (You do have them on paper, don’t you? If not, you should do this too. Either consult an attorney who specializes in advance directives or visit the many websites that have forms you can download and complete. A number of respected medical centers, such as Cleveland Clinic and Mayo Clinic, have related information on their websites.)
Don’t breathe a sigh of relief yet. What if your s.o. isn’t able to speak on your behalf when the time comes? He/she might be deceased or mentally impaired, or might even be in a similar situation–unable to be your spokesperson. And some of us don’t have partners in the first place. We need to be prepared in these situations, as well.
The most likely people to make health care decisions for you later in life will be your children. And if you are in midlife like me, you have children who are old enough to participate in discussions now. They are old enough to listen to what you want done and not done in the future, when you are unable to tell the medical staff yourself.
For those of you who have advance medical directives, you’re probably thinking, “Why should I have such an uncomfortable discussion when my wishes are already written in legally binding documents?” I can tell you firsthand, those documents aren’t flawless. Some address only general actions that prolong dying, such as the use of respirators. They might not take into account how the person will live from day to day, week to week, for the rest of their lives. At a stressful time, do you want your family members to have to interpret exactly what you want? More likely, you’ll want them to be confident they know precisely what decision you would make if you could.
Got all your papers in order? Good. Now for the hard part–the talk. Pulitzer-prize-winning columnist Ellen Goodman’s own experiences spurred her to make this as easy as possible for you. Along with the nonprofit Institute for Healthcare Improvement, she founded The Conversation Project, which, according to its website, is”dedicated to helping people talk about their wishes for end-of-life care.” The Conversation Project wants people to have end-of-life conversations in an informal setting, long before decisions have to be made. To this end, they have developed a “starter kit”, which you can download from their website here.
The 12-page starter kit is broken down into steps, beginning with questions aimed to ignite your thinking process and put into perspective how you view your end of life. From there, the kit gets you to plan things like whom you want to take part in the conversation, when/where would be a good time and place to have it, and what you want to cover. It ends with a list of “where to go from here” topics, like what you might want to say the next time you speak to your family or what you can do to record your wishes in legal documents. (I suggest you do things in the other order: documents first, conversation later, but, I suppose, the important thing is that both are completed.)
Our personal experiences prompted my husband and me to meet with an estate planner this past year and put everything in writing. For the most part, we want the same things. But we differ in a few areas too, and, I admit, I might not have guessed my husband felt differently.
After drawing up these papers, I spoke to my two adult children about my wishes. It wasn’t uncomfortable (at least not for me). I didn’t do anything formal like The Conversation Project suggests, but I did voice my desires over the telephone.
Additionally, I told my older children about the difficult decision my sisters and I had to make a number of years ago, when our mother could no longer speak for herself. I explained to them what we had to decide, my feelings about the particular circumstance, and why I felt that way. I hope that in the future, they will view this conversation, and the others I plan to have with them, as a comfort.
Of course, I hope that they won’t be left to make such decisions for me, but I’m well aware we can’t all die in our sleep at a ripe old age–healthy one minute, gone the next.