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Talking Through Tension: How to begin difficult conversations03/14/2019

The idea of talking with those we love about a time when they will no longer be with us can feel too painful to bear. In a perfect world, we could avoid the unpleasantries, pass away peacefully and leave a tidy situation for our families.

This is rarely the reality. Avoiding preparation for death often leaves families in legal and financial turmoil. Even before death, individuals may become incapable of being their own healthcare decision-maker and need someone else to. If a family does not know the wishes of the individual's decisions like keeping someone on life support can cause rifts and lasting guilt.

As nice as it would be to have a cookie cutter approach to death, no family is the same. A mother and daughter pair of best friends may avoid this conversation, not despite their closeness, but because of it. A husband and wife may not be able to think about this talk because of the pain of imagining a day without their spouse. Estranged families may find conversation about the weather daunting, never mind an emotionally raw exposé on each other’s wants and needs. Talking about death and preparing for it is overwhelming, no matter your family model, but it doesn’t have to be.

Personal/Financial documents

People tend to think about death preparation as just a will or trust. Wills are important documents that should be prepared with legal counsel in order to ensure your assets go to whom and where you intend. Outside of this process, there are simple things that an individual can do to get their personal affairs in order. Create a folder including (but not limited to):

  • Your legal name and Social Security information
  • Birth and marriage certificates
  • Employment information
  • Bank account information and access
  • Recent tax return
  • Car title and deeds to property
  • Insurance information with policy numbers
  • Medication list and instructions
  • Names and numbers of friends, family and doctors
  • Information on accessing your will and legal documents
  • Pet’s medical and care information

Be sure to list any and all income sources and how to access them, as well as any debts and upcoming bill information. Make sure to update this folder regularly and have someone who knows where it is. For more items you may wish to include, check out www.nia.nih.gov/health/getting-your-affairs-order.

Health Care Advance Directives

Families need to also prepare for end of life transitions and care. At some point in the dying process, you may lose the ability to communicate your wants and needs, so it is of the utmost importance to discuss your wishes with your family while in good health and create HealthCare Advance Directives. These include:

DNR - A Do Not Resuscitate order asks that medical professionals withhold CPR should your heart stop beating, or if you stop breathing

A living will - This is a statement about the type of medical care you wish to receive if unable to make your own decisions, such as if you would want to be kept alive on life support. Fivewishes.org is a legally valid document that walks you through different types of decisions to consider in various situations

HealthCare Surrogate Decision - This document names the individual who is legally able to make medical decisions for you in the case that you are unable to. Floridahealthfinder.gov provides guidelines and examples of these documents.

Getting Started

The list of things to take care of and discuss can seem daunting, but there are tons of resources. The most important thing for you to do is to decide what works best for your family and dedicate your time to getting started.

Deathoverdinner.org asks questions about the type of conversation you are trying to have and tailors resources for your goals of the conversation. The site selects readings and videos for you to share with your family to check out before coming over for dinner and having a meaningful discussion. This is a great tool for those who aren’t quite ready for the specific details of death but want to start the conversation.

TheConversationProject.org is another great resource. The site provides detailed conversation starter kits about the dying process, Alzheimer’s, choosing a health care proxy and more. These kits ask practical questions about a person’s feelings towards all facets of the area and help facilitate a great conversation between individuals.

The 40-70 Rule

While death is certainly the most final, it is not the only difficult conversation to have with your aging loved ones. Many face the difficult decision of discussing when their parent should move in with them or stop driving. Aging parents also struggle with these conversations,unsure how to approach them without worrying their children. The 40-70 Rule: An Action Plan for Successful Aging empowers individuals at least 40 to have these conversations with their parents in their 70s, available at caregiverstress.com


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