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You can’t avoid tough topics forever. Use these steps to prepare for the talk and break the ice.
The dinner table is often the place to gather with family and friends to talk about everything from politics to sports to the latest shows we’re binge-watching. Nothing is off limits.
Except, of course, the tricky topics. After all, subjects like wills and health directives aren’t too fun to talk about. As we get older, though, those topics really need to be addressed with the people closest to us. In a recent national survey from The Conversation Project, 92% of people agreed — but only 32% had actually brought them up.
“It’s definitely anxiety-provoking for the older adult — and for family members and friends, too,” says Ellen Flaherty, director, Dartmouth-Hitchcock Centers for Health and Aging. “But it’s really important to start the conversation early. Waiting until you’re in the emergency room isn’t the best time.”
These types of conversations aren’t easy, but they are important. To help you get the ball rolling, use this guide to know what you need to discuss with your loved ones — and how to bring up the subject. You’ll also find useful strategies that can help you prepare for these late-in-life matters.
Prepare for Conversation #1: Your Health Care Wishes
A life-threatening situation can happen out of the blue, so the older you get, the better it is to be ready — just in case. You’re fine now? Great. But if an emergency strikes, you may not be able to let your loved ones know exactly how you’d like to be cared for.
Some questions to ask yourself: Would you want to be kept on life support in a prolonged coma? Would you be OK with a feeding tube during a terminal illness? What are the circumstances under which you’d want doctors to perform CPR if you’ve stopped breathing?
Those are very tough questions — and you don’t want your family members to have to figure it all out on their own in an emergency situation. There’s no time like the present to get started on these simple steps.
Think about your wishes. “You need to be the gatekeeper for your own health care,” says Angela Mattie, professor and director of the long-term care program at Quinnipiac University. “These aren’t things we want to put on top of our to-do list because they take us to a place we don’t want to go. But not thinking about them now may end up prolonging our lives in an uncomfortable state — with the same outcome.”
Not sure what your wishes would be? This exercise can help: “Think about a situation with your parents or another relative where you looked back and thought, That was a good, peaceful death,” suggests Flaherty. “Or did you have just the opposite experience, where everything seemed to go wrong?”
What do those experiences tell you about what you want the end of your own life to be like? Use your answers to begin making a list of your wishes, says Flaherty. For more guidance, check out the Centers for Disease Control and Prevention’s Complete Care Plan checklist here.
Pick your proxy. Spend some time thinking about who you’d like to speak up for you if you can’t speak for yourself. This person would become your health care proxy.
It may be an adult child, a close family friend or a trusted adviser. Their official title will vary from state to state, but the role will stay pretty much the same: to make health care decisions for you should you become unable to do so.
Talk to your doctor. Based on your personal health history, your doctor can help you start tweaking your end-of-life plan. When you’ve completed your plan, your doctor will add it to your medical record.
Document your wishes. Even if your doctor has your end-of-life plan on record, you may have other legal forms to fill out to secure your health care wishes. Almost every state has its own Area Agency on Aging. These offices connect older adults with all of the information and planning resources they’ll need. Or you can simply download everything from the internet — just be sure it’s specific to your state.
You don’t have to dot every i and cross every t right now. The important thing is to get the process started, Flaherty advises. “It’ll help you have a good understanding of what you want to accomplish,” she says.
Be Savvy About Advanced Directives
To better understand end-of-life planning, take the Advanced Directives online learning course from Renew. The easy-to-follow lesson covers what you need to know about an advanced directive, plus ways to talk about your wishes with your closest family and friends. Learn more here.
Prepare for Conversation #2: Your Finances
You may not have a Bill Gates’–size estate, but you likely have at least a few financial assets to leave behind, from your house to your savings to some treasured family heirlooms. Now’s the time to make a plan for how you want it allocated when you’re gone.
“There’s no greater gift you can give your adult children and relatives than to have everything explicit in terms of your finances,” says Mattie. “Not only will you preserve as much of your assets as possible and avoid too many estate taxes, but even more importantly, you’ll minimize any bad feelings or rifts between siblings or other loved ones.”
Everyone’s situation is different, of course, but these three basic steps always apply.
Think about your assets. How do you want them distributed when you’re gone? If you have children and grandchildren, you might leave almost everything to them. Or, you may want to give something to close friends or a beloved charity. Jot down some ideas to get started.
Gather your documents. To prevent confusion later on, pull together critical financial documents today. Include the basics: your birth certificate, Social Security card, insurance policies, bank records, tax returns, credit card info, passwords to online accounts and your power of attorney form. Put everything in a safe, easily accessible place, says Mattie.
Enlist your experts. Find a lawyer to draft or update your will and a financial adviser to help you set up your estate, says Mattie.
“You really need someone you can absolutely trust — don’t put it off,” she says.
You’ll want to pick someone to act as your power of attorney agent. This person will make financial decisions for you if you can no longer make decisions on your own behalf. Also choose a trusted relative or friend to be the executor of your estate.
“This person will tie up all the loose ends when you’re gone,” she says.
How to Start the Conversation
Now that you’ve done all the prep work, you’re ready to sit down and have that talk with your loved ones. Feeling a little nervous? Don’t worry. You’ve already done the hard part — the experts you’ve consulted and the forms you’ve filled out will help guide your conversation.
“By doing all the advance work, you’ve made it easier for your children or friends, and you’ve modeled a thoughtful way to handle this difficult talk,” says Jennifer Crittenden, Ph.D., associate director of the University of Maine Center on Aging. “You’re signaling that these things are important to you and you’d like them to be aware of your plans.”
Get yourself ready for a smooth, productive conversation:
Make time for the talk. Be proactive — don’t wait for the opportunity to magically happen. “Actually scheduling a time to talk in a calm, thoughtful environment is really important,” says Flaherty. “Let your loved ones know, ‘I’m fine, there’s nothing to worry about, but I’d like to talk now, while I’m able to have the conversation.’”
The best setting? That depends. “It’s probably not when you’re sitting down to Thanksgiving dinner and the timer is going off for the turkey,” Flaherty advises. Instead, find a quiet place and make sure you’ve got plenty of time.
Find a natural opening. You might latch on to something that’s happening in the news, says Flaherty. For instance, you might say, ‘With the pandemic going on, I’m a little worried, so if anything happens, I want you to be aware of my wishes.’ Or you could bring up an article you’ve read or a seminar you’ve attended on making these plans.
Practice makes perfect. Go into the conversation armed with information and a good idea of exactly what you’d like to say. “Prepare as much as you can,” says Flaherty. “Do a role-play with the social worker at the local senior center or talk with your friends about how they’ve handled a similar situation. The more you talk about it, the more comfortable you’ll feel when you bring it up with your loved ones.”
Take a deep breath. After all, this conversation is a way to show your family and friends how much you care about them. “We don’t want to burden our loved ones with mowing our lawn or taking care of us,” Flaherty says. “And we certainly don’t want to burden them with making all these difficult decisions. Let your family and friends know, ‘I’m having this conversation because I love you and want to make this easy for you.’”
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