End-of-life discussions involving a loved one pose challenges for most families. Some persons with limited life may be too private to engage in discussions and decisions with family, while others comfortably share their decisions with close family members that will assume responsibility to act on a family member’s end-of-life choices. Even those members may be uncomfortable in their role due to a belief that discussions minimize needed hope for a dying person’s continued treatment. End-of-life discussions also place “front and center” a dying person’s and family’s need to face their own mortality, an unsettling issue for many.
Experts in end-of-life, however, note great value in talking about one’s plans for anticipated remaining earthly life, even if that person seems to be healthy. Most end-of-life practitioners encourage adults to assume values and attitudes of dying patients (the real experts) to free themselves from future end-of-life struggles with limited life. Practitioners and dying patients recommend the following to individuals and families for talking about end-of-life issues, particularly when a family member has a life limiting disease:
- Evaluate life priorities to support meaningful work and relationships (follow the adage, “the most valuable things in life are not things but people”); prioritize time with family members during wellness and particularly at end-of-life periods.
- Share deep feelings and have meaningful conversations with those you love to connect with one another; people are moved deeply with sharing of common values and support/love for each other. Regular expression of “I love you, I forgive you, please forgive me, and thank you,” as part of family communication, build relationships and improve the quality of life of all family members.
- Prepare for the worst: make sure a family member with life limiting disease has an advance directive to clarify the person making decisions on behalf of a loved one unable to exert their choices; share that document with responsible persons for a meaningful conversation; unfortunately, only 34% of healthy people have an advance directive, despite their limited predictive knowledge about when they may need another to make decisions on their behalf.
- Involve health care personnel in end-of-life discussions; Medicare covers those without a co-pay or deductible; increasingly, medical and health professionals receive training to insure patient well-being during all phases of life, including the dying process; Medicare covered benefits such as interdisciplinary team services, hospice, and palliative care help improve the quality of life when one’s life becomes limited.
References: Fields, L. (2018, July 2). Life lessons from end-of-life experts. https://www.nextavenue.org Johansen, B. (2018, July 19). How these medical schools are improving end-of-life instruction. https://nextavenue.org.