Communicating End-of-Life Wishes
More folks are realizing it is a natural and necessary way of alleviating pain, misunderstandings and of bringing considerable peace of mind for the whole family.
Talking about end-of-life decisions and final wishes would probably never be ranked by anyone as the most pleasurable or anticipated conversation. But those conversations between parents and their adult children are among the most critical of family discussions. It is also among the most unselfish and loving things that one generation can do for another.
I suggest that the parents initiate the conversation. It is a mature thing to do, and is a life-gift to their adult children, who will be eternally grateful. If, however, it is the adult children who take the initiative, I encourage the parents to honor the request, and then share as much information as possible about their preparations and personal desires for the inevitable end of life. Many midlife-and-beyond people have told me that when one generation opens that sometimes scary door into their most personal wishes, their children will open up to ask questions and share their own thoughts.
What makes it so hard?
As recently as the 1970s, a majority of the older generation would not think of discussing the inevitability of death with their adult children. Many considered it a burden that their children should not have to bear. However, more folks are realizing it is a natural and necessary way of alleviating pain, misunderstandings and of bringing considerable peace of mind for the whole family. Men especially would not think of discussing intimate details about their financial situation, about medical intervention at urgent junctures or the funeral. They consider it inappropriate, even with their wives, let alone their adult children. On the flip side, adult children seldom initiate the conversation with their parents. Some consider it disrespectful. Many just want to hide from the truth that their parents will eventually die.
Times are changing!
Fortunately, in the 2000s, that trend is reversing, for myriad reasons. There are countless resources outlining the importance of end-of-life discussions. They're readily available in doctor's offices, at your church, through your attorney, banker or financial advisor. The topic is explored in helpful and frank ways in the media, on websites, in newsletters and seminars.
If you haven't been to a doctor's office or hospital in a while, you may be surprised to learn that the standard questionnaire you fill out now includes questions like:
- Do you have a living will?
- Who is your power of attorney, and do they also have medical power of attorney?
- Do you have an advance directive in the event you are unable to communicate?
Another reason for increased disclosure is that people are living much longer, and medicine has become so advanced that people can be kept alive for years beyond their ability to function with any kind of normalcy. And finally, parents and the children themselves are hearing stories of the benefits of open communication years prior to mother's or dad's death. Not every parent dies of old age and unexpected things happen, so the earlier the conversation can take place, the better.
One Family's Story
My passion for this subject comes from firsthand experience. I'd like to give you a rather personal peek into our own family situation.
My parents were among those who considered the subject of their finances, details about their estate and funeral arrangements pretty much off limits to my brother, sisters and me even though we were at midlife ourselves. They just had a trusting attitude that everything would work out when the time came. After all, we were a loving family, so there would be no problems among the siblings. And our parents thought that maybe their wishes were not the most important thing. That was a hallmark of a generation born in the early 1900s. They were middle class people who had provided as best they could for their future. But then an unexpected illness, a nursing home stay and a bill for $250,000 — following an emergency helicopter transport and a 45-day hospital stay — turned their lives on end.
In 1987, our father, never sick more than three days in his life, was suddenly stricken by an aortic aneurism. His doctor pronounced his death as imminent, but thankfully, the Lord had something else in mind, and we brought him home. I was the youngest child, and as so often is the case, both my mother and father's well-being and care became my primary job and I moved in with them.
At first, the crisis was one of health, but quickly it became more complicated. I knew little about their true financial situation. It was just assumed that the eldest child would handle things when the time came for major health, financial and life issues that would accompany our parents growing old. But she was in a different state, and her husband was very ill himself. So I was thrown into the unknown in the middle of chaos. One learns quickly when there's no other alternative than to learn and act.
But if we could do it over, I know we would all prepare more adequately. Were they debt-free? What bills needed to be taken care of immediately? Did they either one have a will, a living will? Did their banker or attorney know their true situation? Would we have to help sell our father's business? What did their health and life insurance look like? Could they even remain in their own home? With their death predicted by their doctors to occur in the near future, we all realized that they had not told us, and we had naively not asked them, about their preparation, nor their wishes, for the end of their lives.
Our mother, who suffered with the ravages of Alzheimer's and Parkinson's diseases, had been much more open than our father about her wishes. For example, she didn't want to be cremated. She wanted a vault around her casket. We knew her doctor personally. And, she had already either given her children and grandchildren many of her special possessions, or they had earlier identified those things that would be given them upon her death. But, she had no will at the time, no living will, no power of medical attorney and very little knowledge of their actual financial position, since our father had handled those details.
I held her in my arms as she took her final breath. Her last words were in the form of a question that I never had time to answer before she died. I realized at that moment that had we openly discussed years ago the subject she now probed too late in life, she and I would both have had greater peace.
During the last few years of their lives, we lived in the same house and had precious time to talk. Even then I sometimes had to probe harder than I would have liked to discover their deepest end-of-life wishes so we could respectfully carry them out.
Unfortunately, many families never get the chance to do that — all because the parents and their adult children are too uncomfortable, too busy, too stubborn or too ill-informed about the importance of exploring life-end decisions, while parents and children are both living and competent.
Just Do It. It's a Gift.
Some families sometimes find it easier to entreat a third party to be present when discussing these issues: a trusted friend, a pastor, a doctor, an elder-care attorney or even a mediator, if there are rough spots in the relationship between parents and children or siblings. This discussion is not always easy. But the eternal consequences of not communicating about this time in life that we all will face, negatively outweighs the frequent stress and discomfort that surround these conversations.
One of the biggest and sometimes overlooked bonuses is that subsequent generations will find it easier to communicate with their own parents when the time comes, because they've clearly seen and experienced the benefits. We can be mature role models for our grandchildren and their children.
I promise you will never regret your decision to intentionally engage your adult children in one of the most important and compassionate conversations of your life. Purposefully taking the reins, even if you would rather have a root canal than do so, just may turn out to be the best gift you could ever give your adult children — and one that will just keep on giving from generation to generation.
Copyright 2009 Focus on the Family