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Talk About Difficult

It ended with almost uncontrollable laughing.  That’s how one of our team describes his conversation with his mother about making her funeral plans one day not long ago.  Yes, you heard that right…they talked about her memorial service and had a great laugh together.  My take on that is that once the incredible stress around a topic that no one wants to talk about is addressed, the relief is almost giddy.  We laughed too when he relayed the part about Googling funeral hymns and singing along with his mom the ones she particularly liked.  Trust me; this is not a unique story, and it is only one of the “difficult conversations” families can have.

According to AARP, 70 percent of Americans say they feel that it is important to have an end of life conversation with their family members, but only 30 percent have had that conversation.  The younger generation in the family may not hear the conversations that older adults have among themselves about death and dying, and parents may not want to “burden” their adult children with talk of end of life.  But that will not change the fact that death is a universal event for all of us.  If you are that adult child who would like to help your parent with the conversation, there are some ways to “break the ice” in order to have a productive conversation.

First, you don’t have to start with end of life questions; you can start with some of the more mundane issues about health or medical issues.  Every professional painter will tell you that there is a whole lot of prep work before they even put the brush to the paint.  Start with mentioning perhaps a friend whose parent had a medical episode, and the adult children were not even aware that their parent had a problem with their (fill in the blank…heart, lungs, etc.).  So those same children could not even supply their parent’s physician’s name or the medications they were taking or any of the other details that the paramedics or emergency room personnel had asked.  Or you may even point out that your significant other has all the details on your medical health “just in case.”  Would your parent also wish to have you in the know about their health…just in case?  And there may be certain circumstances…

  • Mom, if your medical professional makes any kind of new diagnosis, do you want to know every detail, treatment options, prognosis, or just the big picture stuff?
  • Dad, if the doctors have treatment options for a condition, do you want to know all the details, or just what your doctor recommends?

And there are some issues that can be clearly laid out in documents for the medical record.  Called POLST in Illinois (Practitioner Orders for Life Sustaining Treatment), it is considered a legal document that becomes part of a patient’s permanent record which states what kind of measures they wish to have applied in emergency situations.  It is more than a Do Not Resuscitate (DNR) order; it covers the extent to which medical professionals should work to sustain them in an emergency.  The Illinois site for this legal document also has suggestions for how to have the conversation.

Obviously, the conversation can get into details like the one I started this post with, but it may not be the first conversation.  We as Geriatric Care Managers also get the call to help families cover these kinds of issues, and we have made this into a form called the Life Span Care Plan(SM).

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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