Posted on: Tuesday, October 17, 2006
How to broach subject of death
By Annie Groer
Washington Post
Gerontologists and other health professionals who work with those facing death say end-of-life conversations generally are valuable to the patient and family. They also concede such conversations are difficult and, sadly, rare. Here are tips they offer to patients and their relatives on conducting such a talk:
It's up to you whether your talk concerns just practical affairs or deeper emotions. The conversation can range from whether a dying parent wants a feeding tube or ventilator to the music he wants played at his funeral, or if he wants a funeral at all, says Capital Hospice chief executive Malene J. Davis, a former hospice nurse.
There are several ways to broach the topic. To a receptive parent, an adult child might open with, "Mom, do you want to talk about this? You know what the doctors say?" suggests Arlington, Va., psychotherapist Robin McMahon. The parent could say, "I'm dying, I'd like to tell you what my life has meant to me."
Another option is to tell a story about someone else, Davis suggests. "You tell them you have a friend who is dying and 'I need to know about what you want, how you feel.' If they close you out, don't give up, go back at another time."
A holiday family dinner is a chance to raise the subject, Davis says. An adult child might begin by expressing thanks for the gift he is about to share: instructions regarding his own death. "Say, 'If I got hit by a truck tomorrow, this is what I would want,' " Davis suggests. Take notes.
It's not always the parent who resists such a conversation. If kids are in denial, McMahon says, "a wise parent fills out an advance directive so the adult child has something."
If parents are in denial, the children can give them a living will, durable power of attorney and other documents and say, "Here it is, read it some time. It's here for when you need it." Parents reluctant to discuss this with their children, or to cede control of their assets, might want a lawyer or accountant to take over their finances.
An adult child might preface money discussions by talking about herself, explaining who knows about her assets before asking her parents to reveal theirs. The question might be phrased, "If I needed to, where would I find your papers?" Davis says.
Remind yourself that an end-of-life conversation can bring peace of mind. Ask a parent "to reflect on the pluses of the last part of their life, to let you be a part of the journey," McMahon urges. "It's a loving thing for parents to do, to leave that for their kids." She adds, "The worst part of not having this conversation is the child trying to figure out what a parent wants at a point when a parent can't decide."
