5 Final Years Conversations to Begin Now

“In a way, your mother was your first love affair. You knew her heartbeat, her voice, her moods, her emotions . . . her eyes were the first you saw coming into this world, just as yours will be the last she sees going out of this world.” – Nancy Cobb, “In Lieu of Flowers”

Who wants to think about a time without their loved ones? Or that moment when you take one long, last look into your mother’s eyes. Someday, your own children will be facing that heartache. “It’s a very sad thing,” noted Harriet Warshaw, executive director of the Conversation Project. “No one seems to want to talk about it so the topic is easy to avoid. In fact, every culture has their own taboos around death,” she said.

For example, in modern-day European-based folklore, death is known as the "Grim Reaper" or "The grim spectre of death.” This form typically wields a scythe, and is sometimes portrayed riding a white horse.

And yet, at an individual level, people do want to talk, Warshaw has found. University of Nebraska at Omaha Gerontologist Dr. Julie Masters agrees, and finds that telling others about her profession often opens the door to interesting dialogues about death. As a result, many times people share their own preferences for the end of their lives.  “In the book ‘Being Mortal,’ author Atul Gawande writes, ‘Death, of course, is not a failure. Death may be the enemy, but it is also the natural order of things,’” Masters explains.

Research corroborates the desire that individuals have to discuss these issues. In a survey conducted by Home Instead, Inc., franchisor of the Home Instead Senior Care® network, nearly three in four seniors who have made plans for their final years have discussed them with their adult children, and half of those did so to let them know everything will be OK.

Masters encourages individuals to begin conversations with the end in mind. Following are five conversations to consider having with these important people:

1. Make sure everyone understands what you want. Adult children can be among the least likely to want to initiate these conversations, Warshaw notes. It’s important you know your parents’ or other older loved ones’ end-of-life preferences and that everyone is on the same page to avoid squabbles at the end. By the same token, you’ll want your own children to know. Make it a collaborative exercise: “Mom, I’ve been thinking about what I might like at the end of my life just so the kids don’t have to worry. What are your thoughts?”

2. Find out what medical options are available. The medical community is an important resource for end-of-life conversations. Start the talk with: “I want to have a conversation about my wishes for end-of-life care.” Try to ensure someone approaching the end of life has regular touch points with the medical community to ensure his or her physical as well as emotional needs are being met.

Warshaw tells the story about her mother who fought cancer for years. After extensive treatments, she explained to family she wanted to forgo further medical intervention; that is, until she heard her grandson was studying for his bar mitzvah. After a discussion with her oncologist, her mother resumed treatments and was able to see her grandson celebrate this spiritual milestone.

3. Discuss your financial goals. Initiating conversations with attorneys, financial planners, life insurance agents and funeral directors can help individuals ensure everything is in order. It doesn’t take much to start these conversations since professionals in these industries are accustomed to dealing with end-of-life topics. You’ll want to be sure to communicate to these professionals’ budget or financial goals, final years’ lifestyle preferences, and how you’d like to celebrate a life.

4. Engage a spiritual advisor for emotional support. Conversations with pastors, priests and spiritual advisors provide both comfort and clarity at the end. Masters tells the story of her family’s qualms about a Do Not Resuscitate order for their father. Talking through the issue with the family priest brought Masters and her siblings much peace and the confidence in knowing they made the right decision.

5. Convey your wishes to your care team. Caregivers, whether they are family or professional caregivers or care communities, play an important role in many seniors’ lives. But oftentimes seniors are reluctant to accept help, or talk about their future care needs. North American seniors surveyed by Home Instead, Inc., focus more on preparing financially and legally than planning for long-term care. Seventy-three percent had made a will, but only 13 percent had made plans for long-term care. Approach the conversation with a sense of working together. “Mom, I’d like to treat you to someone who could help you around the house. You deserve it, and having a little help will make it easier for you to stay at home.”

Having the courage to initiate difficult conversations is a key to successful aging, Masters said.