Sustainable Aging and End-of-Life Conversations

Sustainable Aging and End-of-Life Conversations

It is critical to have aging and end-of-life discussions before an illness or accident because a plan to wait until a crisis arrives on the doorstep is not a plan. Collaboration is key. Co-create the vision. Have the sustainable aging and end-of-life discussions before you are enveloped in the emotions that accompany a crisis. Give the gift of a good death to all of those in your circles by encouraging end-of-life conversations.

The reality is that many other meaningful conversations help prepare our family members and ourselves for aging in a way that is sustainable for the entire family. It is not important who initiates this dialogue, and each conversation is not a one-and-done event but a series of discussions that evolve as circumstances and wishes change. Open, honest communication is crucial to create a sustainable foundation for collaboration between current or future caregivers and the family members who will receive support.

PREPARE FOR AGING-RELATED AND END-OF-LIFE CONVERSATIONS

Begin with the End in Mind

When we begin with the end in mind, we acknowledge the reality that all of us are on a journey with a common destination. The decisions surrounding end-of-life are something most of us will confront, and when we explore wishes with those closest to us, we are demonstrating love and care. End-of-life conversations may be initially uncomfortable and cause us to feel vulnerable but, in the end, empower us and our family members to decide how we want to live and how we want to die.

Curiosity and Vulnerability

Curiosity and vulnerability are two essential strategies that will help you explore all aspects of these sensitive topics. When we approach sustainable aging and end-of-life conversations by demonstrating our own vulnerability, we create a safe space for family members to express their feelings and emotions. Acknowledge that the subject is unsettling and uncomfortable to discuss. Being vulnerable takes courage. Having these conversations takes courage. Sit with the discomfort and then lean into it. Explore your fears.

Curiosity about your thoughts surrounding your aging and end-of-life will help you begin the conversation with others. You may be surprised to find that your reflection on death brought you to an entirely different place than that of your family member. The most important outcome, especially in the early discussions, is to keep communication lines open.

Research Options and Locate Resources

When you have an understanding of the components that will be a part of the conversations, you can decide the order and depth as you progress.

Meet Resistance with Patience

When you begin the process of creating a safe space for open dialogue, it is not uncommon to start the conversation and be met with resistance. When met with a refusal to continue the discussion, table it and revisit the subject later. You may make a small amount of headway during each attempt until you achieve a breakthrough.

FIVE CONVERSATION TOPICS

Here are five conversations that will help you create a sustainable foundation of care.

End-Of-Life Planning

Learn the terms and understand the components surrounding end-of-life decisions. Advance directives are a good place to start because of the importance of understanding your family member’s wishes and ensuring that a person is designated to support and communicate those wishes if required.

Consult with an Elder Law Attorney

Not all Elder Law Attorneys specialize in every field of Elder Law. It is recommended that you locate an

continued from page 15 attorney whose focus matches your situation. As with all professional services, referrals and recommendations are an excellent place to start on your quest to find the right fit.

How to Get Started

You may begin the conversation by asking your family member if there is a Durable POA or a Healthcare POA already in place. Suppose a health care representative has not been designated. In that case, it is an essential first step to ensure that your family members’ decisions are upheld if they cannot share their preferences. It is a good practice to review this document annually to ensure that no changes are desired.

Financial

Conversations about finances are crucial for many reasons. Many family members first notice signs of a family member’s dementia in the bank account. Also, older adults are vulnerable to fraud. Due to the subject’s sensitive nature, it may take years of conversation to reach a place of collaboration. If legal steps are required, it is best and less expensive to manage the process before a crisis.

The most important place to start is to simply know where financial documents are kept. The next step may be to monitor accounts. At some point, more oversight will be needed. Begin the conversations, and don’t

Health

A hospitalization or disease diagnosis can be the first time many family members know a parent’s health and medical details. Suddenly, there is a lot to learn and with a rapidity that is ripe for errors. It is important to know that mistakes and misunderstandings are inevitable in these situations regardless of how well we have prepared. Forgiveness and compassion are important components of a sustainable caregiving experience.

Home

We often don’t think about where we would like to live in 10 or 20 years and what accommodations may be needed to support our lifestyle and abilities. Conversations about where and how a family member envisions their future home are essential because the desires and choices impact the entire family.

When decisions are made under duress, it is emotional. Collaboration is often discarded when all family member’s positions are rooted in fear. The fears that drive the discussions are directly in competition for control. For these reasons, have the conversations sooner rather than later.

Legacy

David Solie tells us that, “Whether they express it or not, life review is the dominant psychological event of getting old…Senior adults focus on reviewing their lives to find what it meant for them to have lived.” He makes clear that this is the primary concern, following control, over an older adult’s present and future. An important part of our role is to help our family members process their life stories in a way that helps them discover the meaning that will continue when they are no longer here. We can only fulfill this important task if we are not in a battle for control over legal, financial, or independence matters.

COMMUNICATION TIPS

How to have sustainable aging and end-of-life conversations is arguably more important than what to say during the discussions. It is essential to be clear on your objectives before beginning. Set an intention. Understand that the ultimate goal is to keep the channels of communication open. This is not a one-anddone conversation. Getting to win/win requires that you maximize empathy and minimize ego. Be curious.

Theresa Wilbanks is a Certified Caregiving Consultant and founder of Sustainable Caregiving. She works with family caregivers to empower them with the resources, skills and strategies required to manage the stress and challenges of caregiving.