Starting the Conversation: End-of-Life Planning, Part I

Many people fear that if you talk about death or difficult topics, the subject may become a reality. In fact, this can be the most powerful time in a persons life and in that of their loved ones; a time for life review, conflict resolution, decision making and a time to say goodbye.

Why We Need to Talk About It

It is so important to have a strong connection with your loved one who is nearing the end of their life. Nothing is worse than the type of grief we suffer when a loved one dies unexpectedly without getting a chance to say goodbye. “Please forgive me,” “I forgive you,” “Thank you,” and “I love you” are the four most powerful statements between loved ones and friends that can heal and strengthen relationships, according to Dr. Ira Byock, a prominent physician in the field of end-of-life and palliative care.

When To Start The Conversation

The best time to have this type of conversation to find out more about your loved loves and their choices, and to make your wishes known to your loved ones, is when you are active and healthy. This is a time when you can connect with loved ones and share a discussion without the emotional impact of the topic and fighting back tears at the end of life.

What Would We Need to Talk About?

If you were nearing the end of your life what would you want your loved ones to know about you, your feelings and your choices? And if you thought about your elderly parent, your spouse or your adult children and what would happen if they came to the end of their life because of illness or injury, what would you really want to know about them? Some common themes for discussion:

• What someone is thinking and feeling about the ultimate end of their life.
• Where do we go after death.
• Regrets about life lived and opportunities missed.
• Conversations and business unfinished.
• Do you know that you were and are loved?
• Choices for our care at the end of life.

How Do We Start The Discussion?

Someone just needs to start the conversation! Research has shown that most people do want to talk about what is happening to them or loved ones, but they are afraid to cause anguish or hurt feelings. Research has also shown that end-of-life conversations and choices made known ahead of time have a positive impact on relationships and on the emotional outcome of care.

Fortunately, a process called Advanced Care Planning has been set up in Canada which can assist you starting the conversation and help to guide you in the in the types of concerns to cover. Everyone should have this discussion, record their choices, and give copies to their loved ones, physician, and lawyer. A 2012 national poll found that 86% of Canadians have not heard of Advance Care Planning and less than 50% have actually had a conversation with family members about what care they would want if they were ill and unable to communicate. Of those that have initiated Advance Care Planning, less than 30% have shared it with their physician. No one can predict when and how they will die, but you can make your wishes known by taking action to start this conversation!

Tomorrow we will go into depth on Advanced Care Planning and advanced directives.