It's almost hard to imagine, in a world that tweets every twinge of emotion and uploads images of every meal, that there are any secrets left. But, ironically, the very things people tend to keep close to the vest are the things that most need to be talked about—at least with their loved ones.
Many of us find it much easier to talk about superficial things, even with our families, than the things that really matter, like end-of-life care. We get it; it's not the most cheerful of topics. And life is busy, so there always seem to be more important things to discuss.
End-of-life care doesn't come up naturally in conversations, and it's hard to bring up. But if you find a way to have the conversation, you'll be glad you did.
Parents often don't bring up end-of-life wishes because they don't want to upset their children; children don't want their parents to think they're, well, trying to get rid of them. There's a cultural norm in our country that death should be talked about as little as possible, and avoided at all costs. There's also a natural reluctance to let go of the people we love. These forces combine to reinforce our silence on this topic.
But the reality is that we all die. We may not have much say about when or how. But to the extent that we do, letting loved ones know our wishes can prevent pain and suffering for everyone, and offer peace of mind for everyone.
To the extent we do have discussions about our wishes for the end of our lives, they're often vague and prompted by seeing a TV show with a character in a coma or hearing a news story about someone who is gravely injured and on life support. Somebody watching with us might say, "Ugh. If that ever happens to me, just pull the plug." And then the conversation turns to other things.
You may not have even clarified for yourself what you would want done for you in specific circumstances, such as terminal illness, dementia, or permanent unconsciousness. It's helpful to sit down with an elder law attorney who can present you with common scenarios and available interventions, and give you the opportunity to weigh and process what you might want done for you in each case.
It's easy to talk about "pulling the plug" when it's a purely academic conversation. What happens when it's a real person, and you're standing at the foot of a hospital bed, being asked to make a decision about the life of one of the people you love best in the world? What if there was no chance of recovery, but they could survive indefinitely in a persistent vegetative state? Would you be willing to have nutrition withheld and let nature take its course? Or would you have nutrition continued, but agree that no extraordinary measures should be taken to save life if they went into cardiac arrest? The reality is, there is no "plug," only a series of difficult and painful decisions to be made.
Now: imagine it's you in that bed, and your spouse or children need to make those difficult decisions without knowing your wishes. Do you want them to be haunted by worries that they made you suffer too long or let you go too soon?
You may not have even clarified for yourself what you would want done for you in specific circumstances, such as terminal illness, dementia, or permanent unconsciousness. It's helpful to sit down with an elder law attorney who can present you with common scenarios and available interventions, and give you the opportunity to weigh and process what you might want done for you in each case. Those wishes will be incorporated into your advance health directives.
Once you've prepared an advance directive or directives, you can let your loved ones know where those papers are. It's up to you if you want to talk about the specifics, but they will be comforted just knowing that you've prepared. If they express concern that you're thinking about the end of life, you can tell them that you read a blog post and it got you thinking about the need for peace of mind (yours and theirs) about these issues. And, of course, you can pass this article on to them. They may want to do some planning of their own.
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