Should I discuss end-of-life issues with my father and how can I bring that up in an appropriate way? OR should I ask his pastor to do this?

There are two sorts of ‘end of life’ issues. One is ‘what happens after death’. Perhaps your father is clear about his beliefs, perhaps a visit from his Pastor would let one of them bring it up. You don’t actually need to know what your father thinks about this, so just make sure he has the opportunity to talk about it with you if he wishes.

The other ‘end of life’ issues are practicalities like ‘what happens before death’- what sort of interventions he wants, or wants to turn down. Because Hospice involves a decision to provide comfort rather than to prolong life, it usually covers most of this. Hospice may have suggestions about how to deal with any more issues.

Other ‘end of life’ practicalities are about funeral wishes. Our family has always gone for a decent minimum. Unless you and your father feel strongly about this, it’s probably best not to make promises that will be very expensive to carry out.

One helpful conversation might be about any gifts your father would like to make from his possessions. Small personal items don’t necessarily have to fall into the estate and just get sold, and little gifts set aside for grandchildren, friends or family can have a very special meaning. He might like to make little notes to go with them. Thinking about this will be another way to make it clear to both of you that you are talking about what happens after his death. It may lead to the deeper conversation that you feel you need.

Best wishes to both of you.

These conversations don’t need to be had in “doom and gloom”, crepe-hanging moods and all that. They also don’t have to be hours long. “Hey, Dad, Billy really likes that fishing pole you have. How’s about we give it to him.” And then make sure Billy shows up and thanks him profusely. Another day, “Hey, Dad, I was thinking about that service we went to for Mrs. Jones that time. You think maybe that’s what you’d like? You can talk to Pastor about it.” I’m 65 and don’t plan on going anywhere soon, but I’ve already begun telling my son (my child who would appreciate and take care of heirlooms) about things I have that I want preserved. It’s ok. It’s not depressing and I enjoy telling him about these things. And it gives me peace, even now, to know my prized possessions will be preserved.

You approach it by telling him you know his time is coming. You reaffirm your love and at the same time you can apologize for any shortcomings. You tell him you understand that he must leave you and that you don't expect him to hold on for you, that he doesn't have to linger.

This is the time to tell him any last thoughts. Just be careful not to make death-side promises that you might not be able to keep. I learned how promises can slip out and a deathbed promise can be 'binding' to you.

Lastly, you tell him about the various people he will be reunited with. You can even suggest that he is already seeing them - go with whatever he is ready to deal with. If he says he hasn't seen anyone, tell him that he will at the end - they will come for him.

I have no idea who my mother saw, but someone came for her. With my father, it was my mother who came for him. With my husband, it was his first wife and his oldest brother who had predeceased him.

To witness a passing is a most glorious gift; it is precious.

In my experiences with hospice, spiritual guidance was available. The pastor from hospice who visited my sister let her guide the conversation. You might ask your hospice team if someone skilled in this area would have a talk with your dad.
Our local priest was a great support to us all but the pastor sent by hospice was obviously trained in end of life care. Everyone is different. My sister had questions about death and things she wanted to discuss about her funeral. My dad, true to form, didn't want to talk about anything. I asked him a couple of questions and it was very clear that he wanted to be kept on a strictly "need to know" basis about what was going to happen and he had decided he didn't need to know.
I'm sorry you are going through this rough time.

karen, there is no way to ‘Like’ a question so I sometimes put a response even if I don’t have first-hand insight. This is such a poignant question, and I send you warm thoughts at this time. He is SO fortunate to have you guys and be where he is.

I love margaret’s reply. To marcia’s reply, maybe your dad’s own pastor and the one with hospice can both meet with him. They will be able to guide you in your question - ie, first I think they’re there for you! See what they recommend. Dad probably won’t be surprised when someone initiates, and will indicate how much he wants to talk. Bless you all!

It sounds as if you are giving your father ample opportunity to unburden himself if he wishes to. When you refer to "his Pastor" is this a person he sees regularly anyway? So that there is even a spiritual context in which your father can talk comfortably with someone he knows?

Those being so, I don't think you need worry that your father would like to express his thoughts but can't.

On the other hand. If there are things you want to talk to him about or questions you would like to ask, within the bounds of tact and sensitivity of course, you should feel free. This time is precious to you, too.

KarenFallon after reading your post I could see how much you adore your Father and that's just how it should be. You have Cared so brilliantly well for your Dad and yes I would suggest for you to ask a favourite Pastor of your Fathers to call and visit Him and to Pray with your Father and to prepare Him for death as this will mean so much to your Dad since He's a Man of deep Faith and this will bring Him such great peace. It would be easier for your Dad to talk with His Pastor as He would not wish to cause you any upset. Be thankful to the Lord for having your beautiful Father live with the Blessings of great health in Body & Mind to the ripe old age of 95 years. I wish you Karen and your Dad every Blessing and Peace.

So sorry that you are going through this difficult time.
Does he have a living will in which he wishes are expressed? I would talk to his main doctor about your dad’s prognosis, and what he or she had discussed with your dad. Also, I would ask if your dad was able to understand, and if so, what his reaction was.? Perhaps your dad has expressed his wishes to the physician, so this would be a good starting point. If dad is able to understand what is going on, I would discuss with any involved siblings etc the next step. Eg discussing with Dad “What do you want us to do if X happens, and it looks like you won’t be able to return to your previous quality of life” or something of the like. You could say “the doctors have asked us what to do if x happens, we wanted to discuss with you”. I wouldn’t put this on the pastor, but would of course include him or her if your dad would like their being there.

If you are comfortable talking to your Dad about end of life wishes I think now is a good time. If he and you know your Pastor well maybe you could broach the subject together. Knowing his wishes before he passes will make you more at ease at the end knowing you followed his wishes . Hope this helps

There are many nonfiction reports about people who have shed their physical bodies and moved on to the afterlife. Many living people have seen the spirit of their loved ones who have transitioned over. Perhaps sharing some of these stories would be helpful to both of you.

I too have been caring for my 95 year old father for the last nine years. We've had many emergency room visits and hospitalizations over the years where it was expected that he might have only days to live. I'm thankful that I broached the subject with him because I found that he was relieved to be able to express his thoughts but wasn't sure how to bring it up for fear of upsetting me! He has obviously survived well beyond the initial threat to his life but continues to have challenges each year. We're both thankful that we have an open, on-going conversation to address whatever new need arises. We've extended these conversations to his doctors as well. My dad appears to be comforted that people know what he does and doesn't want, that he has support for his wishes, and that he feels he still maintains some control over the matters of his life.

I see that you've received a lot of wonderful advice here and that you have moved forward with the pastor's help. Removing the elephant in the room and normalizing this part of his life's journey is a kind approach, in my view. My dad and I were long-term members of the Hemlock Society when we were younger so the opportunity for candid conversation was closer to the surface for us. We weren't attending to learn about self-deliverance but because they provided a wonderful education about end of life matters and care in order to plan and prepare. The most beneficial thing I took away was to be able to define what constitutes quality of life at each stage. Your dad can still experience quality if you make the effort to determine which things bring him pleasure. For some it's visits from friends & family, For others it's their morning cup of coffee or their ice cream after dinner. They are things that we might easily overlook as small matters but they take on a greater significance to those whose choices have grown small. I hope you'll make your best effort to figure out as many of them as you can. Look at massage, music, favorite foods, singing, reading to someone, a wheelchair ride to see the leaves changing, old favorite movies, animal visits, sports shows, etc.

In summary, my answer to your question is yes. Involve everyone, especially your dad. It's lovely that you want to be present in the fullest sense of the word in this last chapter of his life.

I would ask whether there is a need to bring up this subject with him. Has he already made preparations for his departure, such as funeral arrangements. will, living will, etc? If he has, why would he need to discuss it? I'm nearing 90 and have made all arrangements for my demise. I don't need or want to know when I'll go, and neither do I need or desire to discuss it. So I would say that it all depends on what preparations he has made.

Perhaps you could put on the hymns and then you might start with something like "When I die, I hope they will sing this
at my funeral." This opened up a conversation with my husband so that I was able to have his favorite person to sing it when the time came. His hospice nurse helped us begin the conversation.

wow. you and I are going thru a very similar situation. and I have also wondered this very same thing and ditto on the uncertainty of time and events in my mother's head. She has been sick a while- pneumonia, UTI , aspiration, and declining It is as though her perception of what is really happening is pretty off. My mother comes from the generation that only says nice things and doesn't mention anything uncomfortable or problems. She is very private and quiet and introverted. She could be bleeding to death but would say she is just fine. My friend who is a Hospice nurse told me not to bring it up unless the situation clearly presents itself. Ours actually did recently. but, in similar fashion to my mother it was vague... On the flip side, it seems to have dawned on her what is happening because at night or when she is really tired she brings up how she is really feeling- as if her subconscious is talking.
I read everything I could get hold of to know what to say. or not to say. I think the most helpful thing for me was something I read that was for starting the conversation and also mentions how to answer or respond if you are not sure; it went like this, - I hate that you are going through__________ , or, Im so sorry that you are having to deal with ________. Some of the Hospice material briefs through this. I guess there is not a clear answer because everyone is so different. Listen carefully to what he says. He may be trying to spare you the difficulty of handling this-

I found as uncle was nearing death my father & he sharing their faith & future together opened all gates of conversation about death. I feel most people feel relieved & comforted that sharing comes about. I also it gives them the ok from you to die & that family will be fine. My brother in law actually said to wife. Let me go. She replied it's I'll be fine. That was something I'd never thought of, giving permission to die. My husband has alz & in bed asks me if it's OK for him to go to sleep. Breaks my heart to think he needs my permission of things.

Why not just talk to him about it? I doubt there is a 95 year old anywhere that hasn't pondered his own passing for decades. I don't think there is a need to subtly go about it. He probably hasn't brought it up since he doesn't want to upset you. What parent wants to talk to their child about them dying. He still thinks of you as his little kid. It's better to have this conversation now when he's still there than to wait too long. Talk to him.

I love my dear family members with the passion of every breath I take, I have a very deep and comforting relationship with my God/Higher Power as I constantly experience her/him as my Guide and Comfort, and I wish my Moving On to be as painless and simple as possible.
I wish to keep living the life I’m living now until I no longer can, and hope that my Loved Ones understand how distasteful it is to me to be fussed over and worried about, and yes, grieved over.
I will expect my loved ones to choose simple quiet means to dispose of my earthly remains, and they have heard me say so many times.
Clergy support will be welcome at the end, as they know.
Other than the above, I’m “needs to know” too. Or maybe even “don’t ask, don’t tell”.
In dealings with others I’m a Teddy Bear, but not for myself.

When my dad was dying of cancer in hospice his pastor went in and had the “you are going to meet your maker” conversation with him. Later that day when I visited my dad he told me it disturbed him. Although dad knew he was dying he held onto hope to the very end. I honored that and basically said my goodbyes when he was in a comatose state. I’m sorry for what you are going through - it is very sensitive. Let your heart guide you.

I'm going to give you not only my opinion based on my own experiences, but on what the research says. I'm an academic who has written about communication and death/dying issues. Yes, of course you should talk to him. He knows that he will die, and to ignore it is disconfirming for him. It implies that you don't care about his feelings. I don't know that I would phrase it as you did, asking whether he has thought about dying. Instead, I'd gently share with him your thoughts about end-of-life for you, and ask him what his thoughts are. I'd gently open up the conversation. You can then ask him if he would like to talk with his Pastor. He's very lucky to have you. I'm glad you reached out to us.

The Pastor.

I would vote for the pastor given the information you have provided. They generally specialize in situations such as this. No doubt the patient is aware of this outcome and you can be free to be supportive in other ways. I will hope for a peaceful end for all at this difficult time.

I certainly think that you should discuss this with him as long as you are comfortable with that. Maybe joining the conversation with his pastor. If he is a believer he may really want to talk about heaven and God's promises.

My husband and I had had a conversation about dying a few days before he died unexpectedly. I had told him that I was wondering if my downward health slide was the beginning of the end. He replied that he had been thinking about this for himself too.
We had taken care of paper work years ago and I recently became a DNR so these things had been discussed on an ongoing process.
As a retired Hospice RN I would say not to actually bring up the subject. He must already know he is failing so wait till he asks questions and answer them truthfully. One patient pulled me down and asked me directly if she was going to die. I answered her honestly and told her she was. She then asked how long and I told her a few days. She then went on to detail the clothes she wanted to be dressed in for the funeral. She seemed relieved by
my answer and quite happy.

The best person to seek advice from is the hospice social worker who should be visiting regularly anyway. Or just call Him/Her and seek their advice

I would do something like ask if they would like assistance getting things in order to make it easier on others. The hospice nurse and pastor can also offer that you will assist him if you like. I used the FCA guidebook with my mom's husband. I think he felt a sense of control and he had me spend one day sorting out the clothes he decided he didn't like anymore. That led him to telling me how he felt about the rest of his "stuff" and him telling me where he had hidden documents. He wrote his obituary in that FCA book and also passwords to his FaceBook, email and Google accounts all with the premise to make it easier for others. The hospice nurse had given us a nice little book and I asked all visitors to read it.....it included the phase of the conversations with dead people. That is a part of the process.