Have “The Talk” with Elders: End-of-Life Issue Conversations


Sex and death. It's odd that those two topics should bring so much anxiety to parents and children. But, there you have it. One – sex – is about the beginning of life. The other – death – is about the end. Both are a part of the lifecycle, but if anything, sex is easier for many to discuss than death.

I've found in my experience that it isn't always the elders who shy away from end-of-life talks. Some do, of course, but many would like to discuss the arrangements they've made for finances, as well as their opinions about what measures they would want taken if they needed someone to make their decisions if they can't, however the adult children often find excuses to put off that particular "talk."

Few of us like to consider the fact that our parents will die. However they will. Nothing will change that fact. Good medical care, solid healthful habits, a pleasant social life – all of these may extend our years, but in the end, we will die.

With this in mind, it is to everyone's advantage to discuss the details at as early a stage as possible. As I told my kids when I had my own legal papers drawn up, "Let's do all of this and then get on with the business of living." We did just that, and while my sons didn't find the prospect of my death fun to talk about, they dutifully listened to what I had drawn up and where I keep my papers.

Whether it is the adult children or the parents who don't want to have the talk, this is something that needs to be done.

How to Start the Conversation

I would suggest two good books, though there are many more, I'm sure. "Creating the Good Will," by attorney Elizabeth Arnold, emphasizes legacy. Arnold has helped guide many families through the process of end-of-life legal work and she sees that there is much more than mere objects to leave behind. Some people, helped by this excellent book, may find that they want to make their values and wishes for their family's future a part of their end-of-life paperwork. The book is worth reading if you are having any difficulty in deciding how to broach the end-of-life talk, no matter what your age or state of health.

The other book I recommend is "The Parent Care Conversation," by Dan Taylor. This book is also about legacy, but has more information about planning how the parent wants to be cared for. It covers legal work as well. Both books offer insight and are worthwhile reading as each has its own strength.

How to Start the End-of-Life Conversation with Your Senior Parent

What I personally suggest to adult children who are afraid to bring up end-of-life work with their parents is that they start the subject by talking about themselves. If you say to your dad "I just read in the paper about a guy younger than I am whose family is fighting over whether he should be kept on life support. I don't ever want to put my family through that, so I've made an appointment with an estate attorney and am going to have all the paperwork drawn up," chances are your once reluctant parents will perk up.

If you are lucky, the parent may even say, "Can we make an appointment to go together?" If not, go ahead and get your work done. Then give your parents all of the information they will need should you become incapacitated. As this all sinks in, the chances are excellent that they will get in gear themselves. You will have made the subject okay to talk about. You will have broken the ice.

One problem, particularly with the older generation, is that the husband will think he should do his paperwork, but not the wife. She may never have held a job and they just don't think that she may be put in a position where she needs a will. If you stress the health directive aspect, the rest should fall into place.

And if it's your adult children who don't want to listen while you, the elders, talk of doing end-of-life legal work? Just do it. Get it done, present your "kids" with the facts, via e-mail if it's more comfortable, and then get on with living your life. You'll all be more comfortable with life, once you know the reality of death has been addressed.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

Minding Our Elders

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I absolutely agree but I want to make sure everyone knows that even though your name is on the end of life paperwork, if you are second, the hospital or nursing home will always go with the first person listed. I say this because my brother is listed first on mom's living will. He hasn't seen her in over 8 years nor talked to her but she never updated this paper. I had to make some very serious life decisions for mom this week and believe it or not, they would not do anything I asked until speaking to my brother. He doesn't give a darn about mom but...he is listed first and gets to decide for my mother. She lived with me the last 2 years but I really have no say now. Sad course of events. Please make sure everyone knows to keep this paperwork up to date.
My mother is the same as the last person discussed. She refuses to discuss any serious matter about her future. She eats healthy but is 81 and weak. She believes if she talks about "negative things" like death and sickness they are then attracted to her, so she won't discuss any practical solutions for the future. She is smart and alert in other ways. I have to clean her room when she visits my sister since she does not want me to invade her privacy. She wants full control of her life, which I try to respect, but she cannot do the things needed anymore. It is hard to reason with a stubborn person who is sharp in some ways and failing in other ways.
End of Life discussions, are in many cases, the most important of any you will have. This is a time to get those answers for both. Not to be approached as a question and answer conversation, rather a gentle unfolding of the life and it's ups and downs.

We need to always be honest and express our concerns is at this time. It is interesting to find frequently the elder is ready for the transition. While adult children are still working through all the emotional stuff, knowing they will soon be at a junction of relationship.

When parents are having problems or emotional negative aspects of end of life discussion, it is most often due to an unresolved issue(s). Adult children can help work through this scenario. This is the time for everyone to get answers to both questions and emotional situations. The time for each child to have honest and frank conversations with the parent is now. Being honest and caring is the best way to begin, these talks. Many times a medical professional will get the ball rolling for us. We do need medical staff to honor this person with telling them when they are looking at the approaching end of life. While a few years ago, it was thought hurtful and crass to tell a person of this diagnosis, today it is considered a bridge for not only the person but also the family.

So when we begin this transition we must be honest. Do not try to soften the diagnosis or to pound it in. Speak in the same tone of voice as any other conversation. Above all, allow the parent to tell you anything they need too. Remember this is the time for them to get all concerns and private memories out.

Adult children will experience a slightly different transition. While they may feel they are ready for the what lies ahead, frequently they are not. It is important for us to remember this is the time to allow our parent to move forward without any baggage. We should get our questions answered, absolutely. We just need to keep our hurt and disillusion to ourselves. This is not the time for a debate rather a good exercise for this talk with the person about their final wishes. Although there may have been discussions regarding visits with family or friends, if they are wanting any religious ceremony or last wishes to be done by us. It is important to listen to them and observe these desires.

There are times when situations in life have left deep wounds in a parent child relationship. Now is the time to work these out. Again doing so only when the parent is in the right place both physically and emotionally. Now is the opportunity to have a constructive talk about what has happened.

It is also very important to remember that all family (both blood and legal) are in a different place emotionally. There is no right or wrong about how one grieves and experiences this step in life. There is no place for use of illicit drugs or alcohol. This time is for clear thinking and embracing life.

If at all possible it is far better to have had some of the issues ironed out earlier than later. Many family have these discussions easily long before the situation arrises. And no matter what role you have allow your heart and mind to go through the grieving process (this includes the person who is passing). As a family we do not need to have this last conversation, rather it is possible, sometimes preferable, to have a professional medical person or religious leader help through this.

Seek answers when you're unable to see through the fog of this transition.