For those with ageing parents, it is not uncommon that at some stage you are confronted by your parent’s declining health and become worried about the future. While death is not a popular topic to discuss over the dinner table, according to advocate Ellen Goodman it’s a conversation that many of us should be having.
Goodman founded The Conversation Project in 2010 to encourage people to talk about end-of-life plans and death.
In her TEDx Talk of the same name, Goodman said that while people understood the importance of these conversations, not many people had followed through with them.
“While 90 percent of Americans believed it was important to have these conversations, only 30 percent of people have actually had those conversations,” said Goodman.
It’s fair to say the statistics here in Australia are likely to be similar. While we are starting to understand the need for advance care planning, many of us still feel awkward about discussing palliative care and our end-of-life wishes.
Goodman’s belief in the importance of bringing dying out into the open stems from her own personal experience with her mother.
While Goodman says she shared an open and honest relationship with her mother, when it came time to make decisions on her behalf Goodman realised how little she really knew.
“I got a phone call from her doctor at the long-term care facility. He said, ‘Your mum has another bout of pneumonia. Do you want her to have antibiotics?’ And I froze. At that moment I realised how little I knew about what my mother wanted.”
While having these highly emotional discussions is never easy, Goodman offers the following tips on how to have these conversations in a way that can empower all parties.
Ask for help
Goodman says that a good way for children to bring up the topic with parents is to ask for help.
“We find it’s often good to say ‘Mum, Dad, I need your help. There may come a time when I need to make decisions for you,” says Goodman.
“When you phrase it in those terms, it’s a rare parent who will say, ‘No, I’m not going to help you.’”
Share a story
Another way to approach the conversation is through a story about a relative or a family friend.
“You can start with ‘Remember when Grandma or Uncle Jeff died. What did you think about it? How would you like yours to be different?”’
“Touching on a familiar experience opens the door to how people experienced it and how people feel about it.”
Talk about values
Goodman advises keeping the conversation focused on what really matters to your loved one.
“Ask them ‘what matters to you’, not ‘what’s the matter with you’.”
Questions can include:
- Who do you want to make decisions for you?
- Where do you want to be?
- Do you want the full range of medical treatments available or would there come a time when you would want comfort care?
- Ask them to finish the sentence: What matters to me at the end of life is …
Such a big topic won’t be wrapped up in one conversation. Keep talking until you can come up with a plan. It’s at this stage you could formalise your discussions through Advance Health Directive or a Statement of Choices document.
Goodman advises that instead of seeing these conversations as an obligation or a painful ordeal, approach it as a chance to speak honestly and bring everyone’s feelings out into the open.
“People are so anxious about having the conversation. But once they do, the huge majority will say, ‘It’s the best conversation we ever had. It was real, it was emotional, it was talking about things that matter.’”
More conversation starters and tips are available at The Conversation Project.