Vail Daily column: A life conversation worth having
While I enjoy almost every day of my job, one of the most difficult challenges I encounter is discussing plans for end of life with family members of our clients and my contemporaries. Not only is the subject emotionally trying, but bringing up the subject matter with loved ones can also create much anxiety.
In our life, we are required to handle many stressful situations. The most stressful, the one that is a life-altering situation, is dealing with the passing of a loved one. This creates so much stress that it is imperative that multiple discussions be held with specific people in order to make certain that all aspects of this situation run as smoothly as possible. This stress often redefines our very core.
When a loved one’s life nears its end, so many areas need to be addressed immediately. It is way too easy to become overwhelmed and thus become immobilized.
Some of those specific topics that need to be addressed are:
• Treatment choices.
• Advanced directives.
• Coping abilities.
• Suffering of both the patient and the family.
• Referrals to hospice.
• After death issues.
For those who have not yet had to experience such situations, the natural tendency is to shy away from the hard discussions. This hesitancy to have these talks, the really tough conversations, can be found in both the health care professional and within the family. Nobody is immune to this type of stress.
It is important to find a place to begin discussions revolving around the end of life issues. Maybe a group situation might make it easier, such as during the holiday season when families tend to gather together. These conversations can benefit from the “safety in numbers” theory and tend to be more philosophical than one-to-one situations.
Generally speaking, there are four steps to expressing end of life wishes:
1. Ask the right question.
2. Record those answers.
3. Discussions among the pertinent people (i.e., family members, loved ones, doctors, attorneys, etc.).
4. File documents (i.e., make certain that the important documents are filed on your computer in a separate file labeled “advance directives” — these papers should also be duplicated and a copy given to your attorney for safe keeping, and a copy should be saved in your safe deposit box for easy access by the family).
There are many, many questions that could be asked, and even more variations in how to ask those questions. Yet, the following few questions would be a good, solid beginning to a productive discussion of end of life issues:
• Who do you want to make the tough medical decisions in the situation where a loved one is unable to do so?
• What types of medical treatments should be used or not used?
• Where would your loved one prefer to die — at home, in a hospice unit or in a facility?
After the difficult questions have been asked and answered, certain documents are prepared from those answers. Those documents are often labeled “advanced directives.” They can include living wills, medical durable power of attorney, and do not resuscitate orders. Here in Colorado, the Colorado Advance Directives Consortium has made available a document called the medical orders for scope of treatment, which is designed to help you convey what your wishes are for medical care at the end of life.
It is obviously one thing to write about what you should do to initiate these difficult but necessary discussions. However, it is quite another issue to face the reality of what to actually say when you are facing a loved one and thinking about how best to break the ice with the topic of death and dying.
Should you choose, there are a number of resources available to assist in starting a conversation: Conversation Starter Kit (theconversationproject.org), Aging with Dignity (www.agingwithdignity.org), and Take Charge of your Life (takechargeof yourlife.org) are just a few that you may want to look into.
When end of life discussions take place between doctors, family and patients, all the participants tend to feel better. Medical treatment is usually handled with more professionalism and is more effective. And, perhaps the most difficult to measure, the stress of such a difficult situation is drastically reduced.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. For more information, go to http://www.visiting angels.com/comtns or call 970-328-5526.