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How to Begin the Final Wishes Conversation

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Collette’s father had a small stroke at age 70 from which he nearly fully recovered. But because he feared another one that could be more debilitating, her dad started the conversation. “He told me that under no circumstances should I allow CPR, intubation, resuscitation or any other ‘heroic measures,’” Collette said.

“Years later he had a heart attack and, while in a coma, the doctor informed me that his only chance of survival depended on his having open heart surgery. When I pressed the doctor to describe what Dad’s lifestyle and quality of life after this surgery would likely be, he told me that IF Dad survived the surgery, he would have many months of difficult recovery in a hospital and would most likely need to move into long-term care. It was easy for me to withhold consent for this surgery because I understood his wishes very well.”

Collette’s father died 12 hours later. “When he took his last breath, I experienced something profoundly beautiful although no words can adequately describe it. It was as if I stood with him inside a portal where boundaries and identities did not exist, only a sublime peace. And still, all these years later, I feel only joy associated with his passing. Together we stood at the threshold of a great mystery, and I have never feared my own death since, and have always been so very happy for him, for passing with such ease.”

Collette’s poignant story, which appears on the Conversation Project website illustrates how sharing end-of-life wishes can bring clarity and comfort to families during difficult hospice and dying situations.

The Conversation Project Starter Kit walks individuals and their family members through a process of starting and completing important conversations. Sharing these wishes could help bring families together, notes the website, which is dedicated to helping people talk about their wishes for end-of-life care.

Following, from Dr. Julie Masters, chair of the Department of Gerontology at the University of Nebraska at Omaha, are tips for getting the conversation started (adapted from “Having the Talk of a Lifetime” (2014); Funeral and Memorial Information Council):

  • Don’t stress. Choose a neutral setting and stay calm when having important end-of-life conversations. Keeping the talk on an even keel will help accomplish more.
  • Have a conversation with someone close to you. Share sensitive topics with close family or friends. Choose someone you trust to talk with or, if you’re helping a senior, make sure they are speaking to someone close to them.
  • Listen and keep an open mind. Certain topics could generate drastic reactions. Always listen with an open mind and don’t be offended by what you hear.
  • Move on if it’s uncomfortable. Unless there is a time constraint, move on to another topic if the conversation is uncomfortable. It may be best to return to a conversation that’s causing distress. Some discussions, such as “Who do you want to care for you if you can’t care for yourself,” can cause angst. Before a crisis happens, tread carefully and try to get the answers you need.
  • Consider using photos and heirlooms as conversation starters. Family heirlooms make good door openers to sensitive conversations. “That’s so nice you want to leave your garnet pin to your granddaughter. What are other things you would like at the end of your life?”
  • Express what you would like to have at your own funeral or memorial service. Sensitive conversations can be a two-way street. Tell your loved one what your own wishes are, which could help initiate the conversation with him or her about what they would like.

“At some point, adult children need to understand they should be the ones making the decisions,” Masters said. “One can’t stay in a child’s role. You have to be the adult in the room and make a decision that is in the best interest and safety of a loved one. That requires a willingness to let go of the old self in favor of the new self. For some people, that’s very difficult. It’s hard to let go. Adult children must mature into a new role – keeper of their parents.”

Remember, discussions should be about how to live to the very end of our lives not just how to die.

Additional Resources:

5 Final Years Conversations to Begin Now
What it Means to Live Well to the End
Compose Your Life Song Music Generator

Last revised: February 23, 2018

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