On Your Health

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How to Have The Conversation About Dying With Your Loved One

Talking about the end of someone’s life is never an easy subject to broach, but it could be one of your most essential conversations. How you will pass from life is a decision that is personal, intimate and important.

Most adults do not have an advance care directive in place and haven’t told anyone what they want to happen when they are dying. But everyone has the ability to guide their health care providers and their loved ones about future medical care at the end of their life.

The purpose of an advance care directive is to honor the decisions you have made about the care you want to receive if you become unable to speak for yourself.

This legal document goes into effect only if you are incapacitated and unable to make your own decisions. In the document, you have chosen what type of medical treatments or extreme measures are taken or refused if you become persistently unconscious or have a terminal, end-stage condition.

These decisions are based on your personal values and wishes, and because it is so personal, the discussion should be had with family and loved ones.

Learn more about advance care directives here.

The Conversation

Dr. J.D. Lackey has made it his personal mission to educate people on the importance of having an advance care directive. He’s seen families fight and agonize over what measures should be taken, if any, to keep a loved one alive when they are in end-stage condition.

Studies show that 90 percent of people believe talking with their loved ones about end-of-life care is important, but only 27 percent have actually had the conversation.

"You need an advance care directive as soon as you become an adult," says Dr. Lackey, who is director of utilization medicine at INTEGRIS Health. "By the time you really need one, it’s often too late. In fact, it’s better to do it when you are still healthy, able and young because it’s not as scary or difficult to think about."

Many people, however, are wary about broaching the subject to their parents, grandparents, spouses or loved ones. To many people, it can feel morbid, but Dr. Lackey says the conversation doesn’t have to be excruciating.

"You should just say, 'Dad, I love you. There may come a time – hopefully a long time from now – when I'm going to have to make decisions for you about your medical care. I need to know what you want and what's important to you. Let's talk about it.' That sentence takes 10 seconds to say," Dr. Lackey says. 

"In many cases, once you've let the cat out of the bag, people are relieved to talk about it. Once you get past that barrier about not discussing unpleasant things, people are often relieved and recognize this is a loving thing to do. It often allows for very intimate, caring conversations you never would have expected."

For those who are hesitant or worried about talking about end-of-life care, Dr. Lackey suggests watching "The Conversation," a video on YouTube that addresses how to approach the subject with loved ones.

The 12-minute video with Ellen Goodman, Pulitzer Prize-winning journalist and founder of The Conversation Project, tackles the talk that loved ones should have about dying. The website includes starter kits to help make decisions.

"I remind myself to watch it about once a month, and every time it reinforces not so much just the details, but just as much why it’s important," Dr. Lackey says. "It's the compassion that Ellen shows when bringing this subject out into the open and having the conversation. She ends with just two questions – have you had the conversation, and will you?"

The Conversation Starter Kit is a useful tool to help have the conversation with a family member, friend or other loved one about their wishes (or yours) regarding end-of-life care. It is available in several languages. All the starter kits are available to download and print for free.

National Healthcare Decision Day

Earlier this week, National Healthcare Decisions Day helped inspire, educate and empower the public and providers about the importance of advance care planning. But the week’s not over yet, so it’s still a good time to discuss the subject with your family and loved ones.

"If you have a thorough advance care directive, you know your wishes will be honored without having to put that burden on your family," Dr. Lackey says. "When should you have one? Right now. As soon as you become an adult. Waiting until it’s absolutely needed is usually when it’s too late."

For more information on advance directives or to download the form, click here.