No one wants to talk about their final days. But as a caregiver, it’s valuable and necessary to have discussions that can help you understand what matters most to your loved ones. It’s important to have conversations about their final wishes before they have a healthcare or medical crisis.
Learn more about your loved ones’ final wishes by having discussions about dealing with health care, legal, financial and end-of-life issues.
Discussing health, legal, financial and end-of-life issues is difficult for most people, but having these discussions will help guide you… if and when you have to make decisions on behalf of your loved ones.
Instead of guessing about what they want, these conversations will help you create a plan that reflects their values, beliefs and wishes. Your plans and decisions will be based on your understanding of your loved ones’ final wishes.
According to a Kaiser Family Foundation survey in 2015, 89% of people believe doctors should discuss end-of-life care with their patients. However, only 17% have had such a discussion with their healthcare providers. Just like most people, many doctors have difficulty talking about death and dying with patients.
According to a survey by The Conversation Project, 9 out of 10 Americans want to discuss end-of-life issues. However, only 3 out of 10 Americans actually end up having these conversations.
Every person deserves to have a chance to express their end-of-life wishes and have them respected.
Do your very best to have discussions with your loved ones about their final wishes. If they are willing to have these conversations with you, they can offer comfort and peace of mind for your entire family.
However, if they are not willing to have these conversations with you, avoid manipulations or guilt trips. Let it be. Remember that this is their life’s journey… and they have the right to do whatever they want to do.
Preparing for Your Discussions About Dealing With Health Care, Legal, Financial and End-of-Life Issues
- Decide who should be involved in these discussions.
- Pick a good time to talk when family members are available for sensitive discussions.
- Choose a location that will be comfortable for you and your loved ones.
- Share your thoughts, concerns and choices with your family.
- Relax and just let the conversation happen.
- It’s okay to have disagreements about some things. You don’t have get everything resolved right away.
- Be patient. Give people time to talk .
- Avoid being judgmental because that can keep some people from sharing what they really think and feel.
- Remind everyone present that they can always change their mind.
- Ask questions respectfully and really listen to their answers. Everyone wants to be heard. It’s comforting to feel heard and understood.
Useful Tips for Your Discussions
I used to work as a Case Manager for a healthcare company which required me to attend meetings with families that are deciding what to do about their loved ones’ declining health. Sometimes, I facilitated the family meetings; and other times, I helped troubleshoot problems.
These strategies helped facilitate those discussions:
- Instead of telling your loved ones what you think they should do, ask them for help planning their care.
- When sharing your recommendations, avoid telling people what you think they should do because that can make them more resistant to your ideas. Instead, you can say: “These are my suggestions.” After sharing your suggestions, you can say: “It’s ultimately your decision. What do you prefer to do?”
- People hate to be told what to do. Especially if you’re dealing with individuals with control issues, you need to give them as much control as possible during the discussion. You can say: “We all understand that you have the legal right to refuse anything. We’re having this discussion so we can understand what you want to do. This is your journey and we just want to know what your wishes are; so, we can respect them.”
Some families are hesitant to have sensitive discussions with their loved ones because they do not want to upset them. Actually, most people dealing with serious health issues find these discussions comforting not upsetting. I’ve had many discussions with terminally ill patients about their end-of-life wishes. Almost all of them wished they could have the same discussions with their own families.
Questions to Ask About Health Care
- Have you thought about who will make health care decisions for you, if you are not able to do it?
- Have you thought about which family and friends you would like to help you with your care, if you’re not able to do it yourself?
- What matters most to you regarding end-of-life choices?
* Relief from pain and suffering?
* Maintaining your dignity and integrity?
* Dying naturally at home, if possible?
* Living as long as possible, no matter what?
* What else is important to you?
- If you’re dealing with a serious illness, how do you define quality of life?
* Being able to do the things you enjoy?
* Being able to make your own decisions
* Being able to maintain your sense of independence?
* What else is important to you?
- Have you talked to your physician about end-of-life issues?
- Do you want life-support treatments, such as, medical procedures, devices or other heroic measures to keep you alive?
- Do you want to be resuscitated, if your heart stops or if you stop breathing?
- Do you want to be at home, in the hospital or in a facility at the end of your life?
- Do you have written instructions about your wishes for end-of-life care? This is called an Advance Health Care Directive; it’s also called a Living Will, Durable Power of Attorney for Healthcare or Health Care Proxy.
Do you know what happens if you don’t have an Advance Health Care Directive?
Hospital and nursing home policies require doctors to use heroic measures to sustain life; for example, it’s standard procedure to use a respirator to sustain life for someone considered medically brain-dead.
If you have specific instructions for your physician and other healthcare providers, you can protect yourself from getting life-support treatments that you may not want.
Questions to Ask About Legal and Financial Issues
- Do you have an up-to-date list of all your assets, debts and other liabilities?
- Do beneficiaries of your life insurance policies, retirement accounts and pensions have the information they need to claim their benefits?
- Have you talked to an accountant regarding your finances?
- Have you talked to a lawyer regarding your estate?
- Have you thought about who will make financial decisions for you, if you are not able to do it?
- Have you given a trusted family member or friend Durable Power of Attorney for Finances? This will give your trusted agent the legal authority to pay your bills or make financial decisions on your behalf if you’re unable to do so?
- If you have an agent for your Durable Power Of Attorney for Finances, does (s)he know where to find all your legal papers, including your will, birth certificate and Advance Health Care Directive?
- Do you have a will that’s up-to-date and reflects your wishes?
Do you know what happens if you don’t have a Durable Power of Attorney for Finances?
A judge will appoint someone to manage your finances. This may mean that you will have to be conserved; this means that someone will be appointed by the court to manage your finances and oversee your care.
Do you know what happens if you do not have a will?
If you die without a will, the court will probate your estate. So, instead of you making your final decisions, this means that the laws of your state will determine who will inherit your properties.
Questions to Ask About Final Arrangements and Final Expenses for End-of-Life Care
Planning ahead can help make your loved one’s wishes known and respected.
- What are your wishes regarding end-of-life care?
- What are your wishes regarding organ donation?
- What are your thoughts regarding burial or cremation services?
- Would you prefer setting up a traditional funeral or memorial service?
- Would you prefer to plan ahead and give your specific instructions regarding your final arrangements?
- Would you prefer to plan ahead and take care of the final expenses for end-of-life care?
Do you know what happens if you don’t make your wishes known about final arrangements?
If they’re not sure what you would have wanted, your family may end up with disagreements and conflicts during the worst time in their life. The more decisions you can make beforehand, the fewer decisions your family will have to make when they’re grieving and dealing with the emotional stress of losing someone they love.
Do you know what happens if your family doesn’t have the upfront cash to pay for the final arrangements?
It’s hard to believe that anything can actually make the worst moments in your family’s life a whole lot worse, but it can happen to you.