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End Of Life Discussions: What Are The Best 4 Tips You Must Know About

When should you have End of Life Discussions with your family?

This is one of the most important conversations you can have with your family or loved ones.

man and woman having a end of life discussion at table

Do you feel uncomfortable talking about death and dying?

You are not alone 75% of Australians and 72% of people in the UK stated death and dying was a topic they were least comfortable talking about.(1,2)

Just remember, death is guaranteed. It is inescapable and it can strike at any time! No matter your age.

Still hesitant to talk about dying. So, when do you think you would realise you have left having your End of Life conversation too later? To say all the things, you have either wanted to or need to say to your loved ones!

Will it be when you are lying in a bed in the Intensive Care Unit of a hospital! Suffering a life-threatening injury or illness, most probably.
You then will wish you had the discussion yesterday!

With the outbreak of Covid-19 and how fast it can change your life and kill people of all ages, we should not limit End of Life discussions to the elderly.

What most of us don’t realise is having an End of Life discussion requires planning. You want your family to be aware of your final wishes and have them followed. The following tips can make this process less difficult for you.

This article will help you to understand what you have to prepare and consider to have a successful End of Life discussion with your family.

It will also guide you on how you can start talking about your End of Life Plans and wishes. It provides practical tips, and it will assist you to have this very important discussion with your family. With the aim for you to share what matters most to you concerning your End of Life, and your last wishes.

End of Life Discussions with Family – How to Prepare

Grey haired lady writing down points to discuss with pen onto paper pad

Have you read our other End of Life Planning article End of Life Planning: How to Start With 4 Questions”.

If not, I would suggest you either read the article or watch the video “Best 4 End Of Life Planning Questions You Need To Answer Before Starting” and answer the 4 End of Life questions before you progress to the discussion stage.
As your answers will provide the foundations for your discussions with your family.

Your responses to the 4 questions will help you clarify what’s most important to you. The questions will also assist you in organising and focus your thoughts about what you want to occur if you became seriously ill or incapacitated including what you want to happen after your death. This process can be confronting and emotionally challenging

By working through these questions and the process involved you will be better informed and clear of what you want and do not want to happen at the end of your life.  These may include;

  • What Palliative and Hospice care options are available in your area.
  • Any other documents such as Advance Care Directives, will, organ donations, type of obituary, memorial services, burial or cremation to list a few.

This will provide you with the focus and the foundation to start your family discussions.

It is important to remember that studies have shown that as many as one third of seriously ill, hospitalized older people are receiving invasive treatments they don’t want at end-of-life, because no one has talked to them about their wishes for future care. (4)

Consider having a practice End of life Discussion

Make a list of points you want to cover during your End of Life discussion. Keep the list short and don’t be afraid to refer to your list during the session.

Your list of points will also be of benefit to you by

  • keeping you on track during the discussion, and
  • ensuring you don’t leave something out that you want to communicate with your family.

Another tip is to group a range of topics together, such as what you would want regarding your funeral. Consider having a practice conversation with your partner or a friend you trust. A rehearsal will make you feel more comfortable with the subject. It will also make you sound more confident as well. 

These tips will assist you to be more emotionally prepared to have your End of Life conversation. 

How to Prepare for End of Life Discussions

It is important for you to give some thought about how you will prepare for your End of Life discussion. This includes what will be the best location and the surrounding ambience of the location to have your conversation.

The following are points you should consider:

  • only have the conversation when you know what you want to say and when it feels right for you.
  • whether having one-on-one conversations with individual family members or as a family group conversation.
  • consider your family dynamics from your experience. It may be wise to inform all parties that you want to talk about your End of Life plans. So, it doesn’t come as too much of a surprise for them.
  • from experience, you will know if it’s best to have a one-on-one conversation with one partner first. Such as the mother or son before a group meeting, including your father or aunt.
  • determine when the time and location would be ideal for the conversation to happen 
  • think about where you’d feel most comfortable having this conversation. You would want to have the conversation somewhere that is private and where you won’t be interrupted. It could be at home, or a park or whilst walking. It should be a place where you’ll feel most relaxed and at ease. So at a football game or hotel may not be ideal!
  • some people would find it less daunting to raise the subject during a relaxed family get together. This could be a family dinner or barbecue on a Sunday where most of the immediate family is present.

Barriers to end of life discussions with Parents

Additional factors you should consider when planning your end of life discussion include the age and thus the viewpoint of the person you wish to broach your End-of-Life Conversation with, as;

  • younger people are often not as concerned talking about the subject. As the concept of death and dying seems so far off in the distant for them – they are not as circumspect about it as many older people.
  • older people may be more uncomfortable and reluctant to talk about death. Especially, expressing their feelings or personal views during a family conversation. They may have come to the realisation that their time to face their own mortality is fast approaching and have not been able to accept it. This will often increase their discomfort about discussing the issue, or 
  • they may just feel uncomfortable talking about death in a large family setting.
  • Alternatively, they may have the perception that death is most relevant to elderly people who are unwell. They don’t view themselves as old. Research tends to support this perspective as over half (53%) of respondents said they hadn’t discussed end-of-life wishes because they were too young, and 43% said it was because they weren’t sick.(5)

93% of people that say talking with your loved ones about the End of Life is important. Only 32% of people followed through and had the discussion. (3)

How to Start End of Life Discussions

Male and female older parents sitting on lounge zooming to family

The way you introduce the conversation with family, especially elderly parents, is essential. To increase their willingness to listen to what you have to say. The following 6 ways to start an End of Life discussion will help you introduce the topic. 

Relate it to your parent’s previous experience

A. Begin by asking your parents to tell the story of the circumstances of how one of their parents died. They will often recall details that they have of the event. This can provide you with an opportunity to begin your conversation with them. An example –

“So, were you sad that Granddad died in hospital and not at home? “ or

“What would you like to happen or change when your time comes?”

B. You can base your introduction based on a family friend or mutual acquaintance who has died. You can draw on a story to develop a conversation of what you would want to happen or would want to avoid in a similar situation.

Recount a Previous Experience You had

C. You could recall where a friend’s parent appeared to have a “Good Death”. Highlighting, they had made an End-of-Life Plan and their wishes were carried out by the family. For example, 

“When my friend’s mother-in-law died, she was in her 80s, suffering dementia, and died at home surrounded by her immediate family as she wished for.” 

D. Alternatively, you could provide an example of a death that was painful and lengthy. When the family disagreed on the type of health care treatment their father should have.

“When a friend’s father was diagnosed with cancer. He endured several operations, various other treatments in which he endured for months. He had a very poor quality of life until he was finally admitted to a palliative care hospital where he died alone.”

This caused a lot of stress and associated guilt within the family. As they were unsure of what his final wishes were. Due to this, you have decided to make an End-of-Life Plan. Have conversations with the family about your final wishes. Regarding the amount and type of medical treatment, you would want to receive.

Directly Relate It To Your Concerns

E. Relate it to your concerns. An example of how you could raise the subject would be by saying

“The current COVID-19 situation has made me think about what I would want to happen if I was hospitalised. Not just with Covid-19, and the type and amount of treatment I would want to be administered. Especially, in the situation that my condition would not improve! So I was thinking if we could talk about this!” or

“I was thinking the other day about what would happen to …., and it made me realise we need to talk about this ..…”

another possible way of saying this would be –

“I know this is a hard conversation to have, but I want to talk about if I was seriously injured or ill what I would want…..”

Use An Example From a Current TV Program or In The News

Use an example from a current TV program for End of Life family discussion quote

F. One more way of introducing this topic is by using an example from the media. It could be based on something you had watched recently on a popular TV program or on the national or local news. The conversation could begin by saying something like:

“Did you watch the episode on ……..…. in which she ……..…. was on life support and the family had to decide whether to turn it off or not? What would you have done in that situation?”

These are several ways you can raise the topic to either plan to talk about it and set a time in the future. Or to start your having the conversation.

Feel free to think about what way you would introduce the topic to your loved ones. I would love to read about your ideas. Just leave a comment below.

Think about how you are going to raise the topic with your loved ones. Feel free to use some of these suggestions as pre-planned opening phrases. These will make you feel more comfortable and confident in starting the conversation.

Try not to worry about saying the wrong thing. The key point you need to remember is, there’s no right or wrong way to start your conversation. Just like a famous sporting brand logo – Just do It.

End of Life Family Discussions

The lack of having an End of Life discussion with family and friends can cause a lot of family upset. Stress and often leads to family disputes that may last for generations.

Poor or lack of communication is one of the main reasons issues arise. This will increase the probability your final wishes for a “Good Death” will either;

Patient on bed in ER receiving treatment from doctors
  • are not known
  • not be followed or
  • even disputed legally through the court system.

This is how family conflicts that you read about, happen. You never think it will happen in your family! Until it does.

As these discussions about your end–of-life planning will lessen confusion and provide clarity about what you would want to happen at one of the most traumatic times your family will have to confront.

Even though these discussions are challenging and often uncomfortable to talk about to loved ones. I sincerely hope you found these practical tips and 6 ways to start your end of life family discussions useful. Just don’t put it off as it needs to be planned for and talked about, sooner rather than later.

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 planning and estate planning.

I would love to read what you have used as your end of life discussion starters and how that went. Leave your comment below.

References

1. How to talk about death and dyingLast updated: 21 August 2019. Website viewed 22 Sept 2021-   https://www.health.qld.gov.au/news-events/news/talk-about-death-dying

2. Deaths set to rise but lack of preparation risks leaving more loved ones upset and confused  By Nigel Barlow – November 4, 2019

3 National Poll (2019) Advance Care Planning Attitudes and Behaviours, Advance Care Planning in Canada Published: 30 July 2019 website viewed 24 September 2021

4. To die well, we must talk about death before the end of life October 25, 2019,The Conversation

5. The important conversation we are saving for later 25 May 2016 By Heather Wiseman  

Frequently Ask Questions about End of Life Discussions

What are the 4 best tips for starting an end of life discussion?

1. Prepare by clarifying what is most important to you at the end of your life
2. List the points you want to discuss with your family during the discussion
3. Consider where and when to have your end of life discussion
4. Think about how best to lead into the discussion with your parents or family

How to best start your End-of-Life Discussion with the family?

– relate it back to your parents previous experiences
– recount a previous experience you had relating to a death
– directly relate it to your concerns about dying
– use an example from a current TV program or in the news

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