Thursday on "Nightly News," Dr. Nancy Snyderman showed us how she confronted tough questions about her parents' end-of-life wishes. It's never easy to bring up this subject. But what's important is to begin.
According to the Pew Research Center, older adults are more likely to have had a discussion with their adult children about what to do with family belongings than they are to have had a conversation about advanced illness care. But when people don't make their wishes formally known, they're more likely to be overtreated than undertreated, contributing to high medical costs.
Below, we've posted several resources for those aiming to start conversations about end-of-life care.
Tips from the AARP on talking with your parents about the future:
- Conversations about living independently
- Asking your parents to think about end-of-life issues
- Driving and transportation for older adults
If you are an older adult planning to speak with your children about caregiving and end-of-life issues, you can learn more in AARP's book: "The Other Talk: A Guide to Talking With Your Adult Children About the Rest of Your Life"
Finally, below are some icebreakers from theconversationproject.org:
When talking to your parents
Ask for help: "Mom, I need you to help me out – I may have to make decisions for you someday and I need to know what you want."
Bring up a family story: "Remember how Aunt Julie died, on a ventilator, in an ICU? Tell me how you felt about that."
Share this story: "I just saw this moving story and I’d love to talk about it."
When talking to adult children
Do the mom thing: "I don’t want you kids burdened with stressful decisions about me."
Point out the upside: "I’m healthy now, but you’ll be grateful we talked about this."
Persist: "I know this is hard, but it’s important to me."
End-of-Life Concerns: What to talk about
This list doesn't cover everything you may need to think about, but it's a good place to start. Talk to your doctor or nurse if you’re looking for more end-of-life care questions.
When you think about the last phase of your life, what's most important to you?
How would you like this phase to be?
Do you have any particular concerns about your health? About the last phase of your life?
Who do you want (or not want) to be involved in your care? Who would you like to make decisions on your behalf if you’re not able to? (This person is your health care proxy.)
Would you prefer to be actively involved in decisions about your care? Or would you rather have your doctors do what they think is best?
Are there any disagreements or family tensions that you’re concerned about?
Are there circumstances that you would consider worse than death? (Long-term need of a breathing machine or feeding tube, not being able to recognize your loved ones)
Are there important milestones you’d like to meet if possible? (The birth of your grandchild, your 80th birthday)
Where do you want (or not want) to receive care? (Home, nursing facility, hospital)
What kinds of aggressive treatment would you want (or not want)? (Resuscitation if your heart stops, breathing machine, feeding tube)
When would it be okay to shift from a focus on curative care to a focus on comfort care alone?
What affairs do you need to get in order, or talk to your loved ones about? (Personal finances, property, relationships)