Talking About the End of Life
Most of us tend to avoid thinking about our own death. Yet studies show that people who consider their own mortality are more likely to make healthy lifestyle choices. Being in denial does not make us happier or healthier.
It is a good idea for all adults to periodically think about all the issues surrounding the end of life. Consider questions such as:
- Do you have a living will, a document where you state your wishes about the treatment you would and would not wish to receive if you had a life-limiting illness and could not speak for yourself?
- Have you asked someone to serve as your healthcare power of attorney (also called healthcare proxy or representative) to make medical decisions for you if you are not able?
- Are your legal and financial affairs in a state where someone can easily access the information and documents necessary to ensure a smooth transition of your estate?
- What are your preferences for a funeral or memorial service? Would you prefer burial or cremation? Do you wish to be an organ donor?
- What would you want to accomplish with the rest of your life?
These are all things best considered long before the subject takes on urgency. But as we grow older, it's even more important to face the prospect of death honestly, to think about what's most important for us to accomplish in the time we have left, and to spend our energy doing those things we want to do. There is so much that can bring closure, peace and a sense of accomplishment to the last stage of life. Even if our health condition is uncertain, there are things we can do to take control. Discussing our thoughts and wishes with family and others close to us is the best way to ensure that our wishes will be honored, and can be healing and life-affirming.
When families are struggling with these conversations, a caring professional may be able to help. Counselors, spiritual leaders, support groups and hospice professionals all offer experienced, supportive guidance to help the person and family spend their last days together with a sense of inner peace.
New resource provides structure for end-of-life discussions
NIHSeniorHealth (http://nihseniorhealth.gov) is the U.S. government's consumer health and wellness website covering topics of interest to older adults and family caregivers. The senior-friendly site is tailored to the cognitive and visual needs of older people with short, easy-to-read segments of information, large print, captioned videos and simple navigation.
NIHSeniorHealth recently added a new module covering issues families face when a senior loved one approaches the end of life. The module was developed by Patricia A. Grady, Ph.D., director of the National Institute of Nursing Research. Dr. Grady explains, "Few of us are comfortable talking about death—our own or a loved one's. While such reluctance is natural, it can leave people unprepared and uncertain of where to find answers, especially when they are needed most. Our goal with this module is to help people learn what to expect during the final stage of life so they can plan ahead."
The end-of-life module offers easy-to-understand, reassuring information about the physical, mental and emotional needs of terminally ill seniors and their families, and suggests resources for maintaining quality of life, such as home care and hospice. It also addresses the often complex concerns that can attend death, including financial issues, advance directives and caregiver support. The experts offer advice about pain treatment, spiritual help, spending meaningful time with family and friends, coping with grief, and practical tasks when a loved one passes away.
None of us has complete control of the moment or means of our dying. However, choices can be made to help us experience this time with a sense of closure and inner peace, in the manner we prefer.
The National Association of Area Agencies on Aging (n4a) offers the free online booklet "Let's Talk: Starting the Conversation About Health, Legal, Financial and End-of-Life Issues" to assist families in having these important conversations.
Columnist Ellen Goodman’s article "It's Always Too Soon Until It’s Too Late: Advance Care Planning with Alzheimer's" recently appeared in the Health Affairs Blog.