Talking to Dad about end-of-life care can feel like a daunting task. It’s entangled with so many topics that are difficult to think about nonetheless discuss.
But establishing an advance directive for end-of-life care is extremely important. So is talking to Dad about his. Today we’ll look at when and how you can bring up this potentially prickly subject.
What’s in an advance directive?
An advance directive is a collection of documents that relays your dad’s wishes for end-of-life care. There are most commonly two parts to the advance directive: A living will and a durable medical power of attorney.
What is a living will?
A living will relay your dad’s medical wishes to his doctor in case he’s not capable of relaying them himself. In it, he’ll convey his feelings about intubation, do not resuscitate orders, organ donation status, end-of-life religious rites and more.
What is a durable medical power of attorney?
A durable medical power of attorney assigns someone to make medical decisions on your dad’s behalf. This is most often a close family member. This person will work closely with the medical team taking into consideration your dad’s wishes as laid out in the living will.
When should you discuss advance directives?
Having an advance directive is a good idea for everyone, and aside from the social awkwardness of bringing it up -- there’s not really a ‘bad’ time to discuss advance directives. However, there are opportune times to bring it up.
If you are setting up your own estate plan including an advance directive, this is a good time to bring it up to your parents. Other good times include life transitions like dad’s retirement, the passing or hospitalization of another family member, after any major medical diagnosis or after a divorce.
How to talk to Dad about advance directives.
Talking about advance directives and end-of-life care can feel intimidating. No one likes thinking about mortality. But you can make this conversation less nerve-wracking by focusing on the benefits of advance directives, looking at third-person examples, and establishing an advance directive yourself.
Focus on the benefits.
Yes, death is one of the possible outcomes one must think about when they’re setting up an advance directive. But if you focus on death, the conversation is going to be really, really difficult.
Instead, focus on the benefits of the advance directive. Focus on the burden it will take off of family member’s shoulders as they’re going through a time of uncertainty and potentially grief. Talk about how empowering it would be to make those decisions beforehand rather than having someone else make them for him.
Discuss how it will allow the family to do the right thing to support dad and his wishes, hopefully alleviating any potential guilt. Having a durable medical power of attorney in particular can cut down on the number of power struggles among family members about who has final authority over these difficult decisions.
Highlight the experiences of others.
Another way to open the door to this conversation is to not come at it directly. Instead, start the discussion by bringing up the experiences of others with and without advance directives.
If you don’t have any anecdotes from your personal life, you can gather some real-life examples like the stories of Miriam, Yitzhak and Andy. Talking about third-person examples allows you to discuss some of these same, difficult topics with a little more distance, allowing you to ease into the conversation.
Lead by example.
One of the best ways to open the advance directive conversation with Dad is to establish one for yourself. Once you’ve gone through the process, you’ll have a natural way to bring the topic up. Having likely gone through some of the uncomfortable feelings first-hand allows you to lend him an empathetic ear.
When you set one up as his child, it also removes some of the presumed burden of being asked just because he is ‘old.’
This might go better than you expect.
If you’ve worried about some of these potential circumstances with your dad, it’s likely he’s thought about some of the same things. He may just not know how to bring it up.
Many people are surprised to find that when they bring up living wills and medical power of attorneys, their parents are actually relieved. They’ve been wanting to discuss it; they just didn’t know how to broach the topic.
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