How to Talk to Your Loved Ones about Their End-of-Life Wishes

Many of our clients have touched my life, changed how I practice, and informed my approach. There is one client in particular that I will never forget. He was 99 years old and came to our office for estate planning. He had just moved to Georgia from South Carolina to be closer to his daughter after his wife died.

When we got to the advance directive, I asked my client about his treatment preferences. After he answered, I quizzed his daughter about any significant changes in his wishes. A sudden change in wishes should be discussed and questioned to rule out any undue influence, misunderstandings, or capacity issues.

“Your father just indicated that he would not want CPR if his heart were to stop and would not ever want a feeding tube. Is this in line with what your previous conversations and what he has stated before?” I asked.

“Well, I’m not sure–we’ve never talked about this before,” she replied.

I was dumbfounded.  This family had avoided any meaningful conversation about end-of-life wishes and estate planning concerns for a very long time, and they were lucky to have never experienced a crisis prior to this conversation.

I still am not sure how a man reaches age 99 without ever having told his family his opinions about his healthcare wishes or his final plans. Perhaps he and his wife had decided to only talk about that in private with each other.

For most families, this conversation comes up at some point (at least in brief conversations like, “Do not ever keep me alive if I get sick like they did to Nancy down the street after her stroke.”); but even for those families that have talked about end-of-life wishes at all, very few have talked about these issues in-depth.

Ask your loved ones about their wishes, and then ask more questions.

When you are suddenly called upon to make decisions for your loved one’s medical care, it is crucial that you know what your loved one would want. Knowing how they feel about life-extending care and where they fall on the quality vs. quantity of life continuum matters.

It may seem morbid to bring up. Some older adults wittily reply with a “What? Are you trying to kill me?” response, but most older adults express relief and gratitude for the opportunity to discuss their end-of-life wishes and treatment preferences. And even if the conversation is uncomfortable, that pain pales in comparison to the pain of making major medical decisions for someone that you had never talked to about end-of-life wishes.

Prepare for the conversation.

Lucky for all of us, there are some great resources on how to have this conversation with your loved ones. In our last blogs, we shared information on Advance Directives, PREPARE for Your Care, the Five Wishes, and Critical Conditions. You can use any of these to guide you through the conversation, focusing on completing the document together instead of having an open-ended conversation. This task-focused approach may be less intimidating for some.

It hardly matters exactly how you have the conversations with your loved ones—it’s just important that you have them. You can always reach out to a professional (an elder law attorney, geriatrician, or geriatric social worker) to facilitate the discussion.

We are passionate about all Georgians completing an advance directive for healthcare. If you have any questions or concerns about the Georgia Advance Directive, please contact our office through our website or by calling us at (404) 843-0121.