End of Life conversations with family are often challenging and emotional.
Planning to have your conversation now at a time and place of your choosing is always the preferred option. You don’t want to have these conversations when you are lying in hospital and your family are in a highly emotional, upset, and confused state not knowing what your wishes are in relation to what treatments and how much medical intervention you would want to receive.
In our previous article, “End-of-Life discussions: 5 great tips on how you can start one today“. I discussed the need to set the stage before having your End of Life discussion.
The article looked at what you had to plan for to ensure you achieve the best outcomes. As end-of-life discussions are not like normal conversations. They should not happen without thorough preparation.
In this article, I will discuss 5 more useful tips relating to End of Life conversations. These tips will make it easier for you to handle possible issues that can arise during your end-of-life conversations with your family and loved ones.
This is the 2nd part of our 2-part End-of-Life Conversation article. Which is part of our End-of-Life Planning Series.
As you are now aware through our End-of-Life planning series articles and videos there are several processes involved in preparing your End of Life plan. Also refer to the article titled The 4 Questions You Need to Answer to Start Your End of Life Planning.
We will delve into how best to handle common barriers likely to arise during your conversation with the family. Understanding these issues will enable you to better communicate.
- what matters most to you and
- what you want to happen as your end-of-life draws near.
Just 13% of adults say they’ve let a close friend or family member know where they want to be when they die (rising to only 15% among over 55s); (1)
Plan Your End of Life Conversation
Don’t think you have to cover everything in one conversation.
Talking about death is difficult for most people. You may need a couple of conversations. Talking about your death with close family and friends is even more challenging due to the emotions that this conversation will raise.
Acknowledge the fact this is an emotional subject and it needs to be discussed openly. So, don’t be surprised that you may not get through all the points you had thought you would in one session.
End of Life Conversations with Family – prepare for Various Reactions
Be prepared for a range of reactions to your End of Life conversations with family. Consider the possibility you could receive negative feedback during your conversation. Family members are individuals with differing views that may differ drastically from your own on this subject.
Family responses can range from supportive and understanding through to hostility and disbelief. It is always challenging to hear difficult and hurtful comments from loved ones.
If you do receive negative or confrontational responses during your discussions, consider what motivated your family members to have such strong points of view. For parents or older members of the family, their perspective is often influenced because of:
- an increasing number of their friends being diagnosed with a range of serious medical conditions, and
- a growing number of their peers dying around them.
These anecdotal experiences will shape their perspective and preferences about death and dying. Many older family members will develop strong opinions about what they want regarding their:
- quality of life in their final stages of life
- amount of medical intervention they want to endure
- type of end-of-life care they would like to receive, as well as
- specific ideas regarding their estate planning and type of funeral arrangements they would want.
The research also finds that the majority of people (79%) agree that quality of life is more important than how long they live for – and 98% of over 65 agreed that their quality of life is more important them than how long they live for. (2)
Remember, to ask yourself – what is the rationale behind how your loved ones have come to have these opinions. Is their viewpoint coming from a place:
- of love and concern about you,
- from direct or indirect life experiences, or
- is it based solely on fear, greed or
- lack of inclusion or perceived involvement in your end-of-life plans?
Besides, the generational or stage of life differences, family members’ personalities and knowledge of the subject which can arise during your discussions.
Be prepared for a range of responses that may arise about your plans and wishes. As these may trigger disagreement, arguments, or tears.
Even the best of friends and closest of families don’t always agree on everyday life decisions. So why would end-of-life decisions be any different!
Be open-minded as your family may raise valid points or areas, they have concerns about. It is not unusual for them to raise matters which you may not have considered initially when formulating your plan.
It is best to acknowledge their concerns and points they raised. Avoid immediately dismissing them as this often only inflames the already emotional situation.
At least you have time to consider and investigate any of the alternative suggestions raised during the discussions at your convenience. This will enable you to make better-informed decisions before you progress further.
Barriers to End of Life Conversations – Dealing with Resistance
Barriers to End of Life Conversations arise and stall discussions due to the resistance of your loved ones. If the initial conversation fails:
- review your approach and timing. Ask yourself what factors may have caused the level of resistance you encountered? or
- why your loved ones were not willing to engage in this conversation with you?
It may be that your family:
- fears you are dying. They may think you are having this conversation as you are suffering from a chronic illness and you have failed to inform them of this!
- Are disinterested or are in denial. As they believe such preparation is unnecessary at your age.
- lack of information about why you are attempting to do this for them. They may not appreciate the benefits of you ensuring you have an end-of-life plan.
What if they don’t want to know?
If you have tried several times to have your End of Life conversation with certain family members with no success you need to consider the reality that they do not want to know or be involved in your plans.
Sometimes people do not want to think about death, let alone discuss it. Even though it will happen at some time to all of us. They may think it is:
- too morbid to talk about., or
- talking about your end-of-life planning will somehow hasten the onset of death
If they are stubborn or intransigent in their attitude towards this topic, at least you are now aware. Look on the bright side. Now you know their views about not wanting to help or being involved with your planning. You now have the opportunity to adjust your plans to deal with this situation. Such as nominating another person to be the executor of your Will or substitute decision-maker on your behalf.
Consider the situation from a positive perspective. You now are fully aware of their attitude. This will enable to make any adjustments to your plans and further motivate you to put into place legal structures which you may have previously didn’t think were required!
Why have another Family End of Life Conversation?
It is common to have more than one End of Life conversation. The initial conversation is usually the most challenging to have.
Some of the reasons for another conversation is you:
- you didn’t cover everything you wanted during the initial conversation, or
- you forget to cover certain points
- you may need to re clarify aspects of your proposed plans.
- family members wish to make suggestions, or
- clarify their understanding of your wishes from the previous conversation.
When to initiate another End-of-Life Conversation?
You should have updated end of life conversations with your family when;
- major changes occur in your life. Such as changes in your health, finances, or personal relationships such as marriage, separation, or divorce.
- when family or professional relationships turn hostile.
- you change your estate planning documents, contacts, or legal adviser.
Why End of Life Conversations – Covid-19
With the current Covid-19 pandemic outbreak waiting to initiate this conversation with family could be too late. The speed and the unpredictability of contracting the virus is disconcerting.
The possibility of dying is certainly higher within various age groups and locations. Delaying in having this important discussion with your family may mean you may never have it.
End of life Conversations with Parents
Covid-19 has caused many parents to be suddenly confronted with the reality of their own death. Media channels vividly portray this on our television screens nightly with constant updates of the number of infections and daily death tolls. You may have sadly experienced this firsthand and understand the impact that the sudden death of a parent or family member has on the entire family.
The pandemic has highlighted several issues around the lack of end of life planning. Many families have become acutely aware that they:
- were unaware of what their deceased parents’ or family member’s final wishes were
- parents and family members never had an end-of-life conversation
- surviving family realise they were unsure what their parents would have wanted done in the circumstances
- discovered the ill family members didn’t have an Advance Care Plan or a Living Will and,
- less than half had an up to date valid Will
These circumstances undoubtedly increased the emotional stress on surviving family members whilst they are grieving the sudden loss of a family member.
The situation is further complicated when the parent or loved one is admitted to the hospital suffering COVID-19. They will be isolated, bedridden often attached to a ventilator as their condition can deteriorate rapidly. Often, they become confused, delirious and unable to make health care decisions for themselves. The immediate family cannot visit them or even attend the hospital.
It is important to remember your End of Life conversation does not have to be done face to face. It may be ideal and what you would prefer, but it may not be possible.
Always consider using technology, such as Skype, Zoom, or Face-time. Even the phone can still achieve the desired outcome.
There are several benefits of having the conversation electronically:
- it avoids the need to wear a mask
- don’t have to worry about social distancing.
- not affected by lock-downs or stay in place orders or the tyranny of distance
- everybody may feel more comfortable communicating this way, even by mobile phone!
Importance of End of Life Conversations with Family
It is important to have an End of Life conversation today. You provide your family with the knowledge and awareness of what they need to do on your behalf. When the time comes to make those tough decisions.
You will also be able to feel confident in the knowledge your loved ones are aware of your final wishes. And will act in accordance with your wishes. Regardless of what the future deals out to you.
Document your End of Life Plans
As End of Life conversations are an integral part of the End of Life planning process you need to put your wishes, as you had discussed with your family, in writing.
The type of documents you need to consider would include a:
- Palliative Care
- Advance Care Plan,
- Advance Care Directive – Living Will
- Legacy Letters or Ethical Will
- Power of attorney
Some of these documents are legally and medically binding and need to be done correctly. To ensure they are valid in the state or country you are currently residing in. Whilst some documents only give guidance and are expressions of your hope and wishes.
These specific parts of your end of life plan will be discussed in detail in up coming articles by Planned Wishes.
End of Life Conversations With Family – Summary
We are usually not comfortable with End of Life conversations. Most of us avoid them and rarely speak about death or dying.
What we have to remember and acknowledge is death is an inevitable part of life and it will happen to all of us
The benefit of having your end-of-life conversations with your family is important. The benefits will far overshadow the fleeting discomfort you may experience. It will make everyone’s life that is important to you a little easier when the time comes.
I hope these practical tips will assist you in this part of your End of Life planning.
If you can just have an End of Life conversation with your partner today about your wishes and thoughts, it may just make such a difference in the end
The reality is that we never know what tomorrow will bring. Be prepared
Remember to subscribe to learn more about our End-of-Life planning. This series also includes articles about legacy letters / ethical wills, power of attorney, living wills or advance care directive, funeral and estate planning.
I would love to read what tips you have used during your End of Life conversations with family and any tips you found helpful. Leave your comment below.
2. Brits failing to talk about dying and risking leaving it too late to make their wishes known 18 May 2015 https://www.dyingmatters.org/news/brits-leaving-it-too-late-make-wishes-known
Frequently Asked Questions
How to have Your End of Life Conversation with Family?
1. Plan Your End of Life Conversation with family members
2. Be prepared for various reactions even negative ones from family members
3. Understand the reasons for barriers to your conversation with your family
4. Plan to initiate another End of life Conversation
5. Consider the benefits of using technology for conversations
Types of Barriers to end-of-life Conversations
People encounter a number of different reactions when having End-of-Life conversations. It is important to understand the rationale behind the different reactions that may occur during your talk with family members?