Earlier this week (Sept. 26, 2012) I was interviewed by and participated in a discussion sponsored by the Huffington Post concerning end-of-life conversations and health-care directives. The participants didn’t agree all the time. But when it came to “The Conversation,” (the end-of-life conversation), there was unanimous agreement.ï¿½ï¿½It can beï¿½the most difficult conversation you’ll ever participate in.
Why do we avoid this conversation? Why is it so difficult? Our lives, for the most part, focus on living – and most of us strive to enhance our lives, to grow and change in positive ways. A conversation about death? About dying? About how-to-die? It may not seem normal – or even healthy. And that is exactly where our thinking needs to change.
Dying is a part of the continuum of our lives. And because every single one of us will die, thoughts about our own death and those of our loved ones, are indeed normal,ï¿½healthy. And just as we spend time planning to welcome new members into our circles, we must also plan for the time when loved ones will inevitably transition out of our circles, through the process of dying.
Assume that your child wants to marry. Most parents would not only want to participate in the ceremony, but assist in planning for the events surrounding the big day. And we may have loved ones in our lives who can be expected to die sooner than others. We need to lend a hand here, too.
What should we be doing? And, what steps do we need to take?
There are two things you should be doing to foster a healthy, robust conversation with your loved one. The first thing is to listen. This conversation is not about you. It’s all about your loved one and his/her wishes, fears, desires, wants, and more. While you may be guiding the conversation, what you want doesn’t matter – your turn will come. What kind of treatment will your loved one prefer? What steps does she want taken? Where would she like to be treated? Who does she want to care for her? And after she has transitioned from this life to death, what are her wishes regarding ceremonies surrounding her death? Where does she want her final resting place to be?
The second thing you need to do is assemble all the information you can. Where has she been doing her banking? What are the account numbers? Does she have a safety deposit box? Does she have any stock, bonds, annuities, real estate holdings, assets like automobiles, jewelry, artwork. Any other assets? What liabilities does she have? Does she have mortgage(s), outstanding rental obligations, credit card debt, other revolving credit debt, any outstanding loans? What are the sources of her income? What are her average monthly expenses? Has anyone been “assisting” her manage her finances? Who are they and how do you contact them? Does she have a Living Will? Has someone been assigned as her Health Care proxy, her Power of Attorney?
What steps do you need to take? After you’ve “listened” to your loved one, and gathered up information, encourage your loved one to establish a Health-Care Directive, aka a Living Will. In a NY Times article, Paula Span notes research showing that less than 30% of Americans have a Living Will. She states that people mistakenly believe that having a Living Will is a license for the plug to be pulled. In fact, however, if your loved one wants every kind of heroic effort to be taken, in spite of the odds, then the Living Will is the document that will help to make that happen. This is the document through which the loved one declares exactly what their wishes are.
If your loved one is in an accident, or has a crippling stroke, or is otherwise incapacitated, she’ll need someone to “speak” to her medical team on her behalf – to be her advocate to assure that her wishes are carried out. She needs to appoint a Health Care Proxy. She’ll also need to appoint someone to have her Power of Attorney. A POA allows the appointee to access finances and operate on her behalf in legal, financial and other matters.
Is a health care directive difficult or expensive to have prepared? In her article, Span says, “Maybe people may think drafting an advance directive is complicated and expensive and requires a lawyer. But forms for every state (state laws regarding advance directives differ) are widely available on the Internet, at the National Hospice and Palliative Care Organization’s Web site or through the National Healthcare Decision Day site, among others. An advance health care directive doesn’t have to cost more than a couple of bucks for a notary.”
Don’t wait to get the conversation started. Do you really want outsiders to step into shoes you should be wearing?