Do You Know Your End-of-Life Wishes? Tell the People You Love

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Whether you are being treated for a serious illness or currently in perfect health, it’s a good idea to speak to your spouse, family, or other loved ones about your wishes for end-of-life care. You may be squeamish about having this conversation: It can be uncomfortable to talk about, and your family and friends may shy away from a discussion. “We are an anti-death society: we never want to think about facing the end because it’s sad and we get fearful,” says Michelle Wulfestieg, Executive Director of the Southern California Hospice Foundation.

But it’s important to have the conversation, and sooner rather than later. Talking about your preferences will help make sure that you have the kind of care that you want at the end of your life; for example, dying at home, instead of in a hospital or nursing home. And it will help your loved ones know that they’re doing what you want, no matter what tough choices they have to make in the end.

Think ahead

Before you sit your loved one down to talk, think about what you’ll value most at the end of your life, suggests Harriet Warshaw, executive director of the Conversation Project, an organization dedicated to helping people talk about their wishes for end-of-life care. And ask yourself, what are the three most important things you want your family to know?

Some questions to consider: Would you rather be at home, with loved ones, or in a hospital with excellent nursing care? Will you want to receive medical care indefinitely, or is quality of life more important than quantity? Will you want your privacy to die alone, or do you want to be surrounded by loved ones? Will you want those closest to you to know everything about your health, or would you prefer to keep some details to yourself?

Plan your five W’s

Who do you want to talk with? When would be a good time to have the discussion? Where would you feel comfortable talking? What do you want to be sure to say? And why do you want to say it?

The why can be a good way to open the conversation. For example: “You know, your Aunt Joan died recently, and it wasn’t a good death for her. Seeing what happened to her has made me think about what I want out of my end of life, and I thought it would be a good time to talk about it.”

Make it about them

Explain to them that you’re sharing your wishes so that they won’t have to second-guess themselves or agonize about making end-of-life decisions for you. “I had the conversation with my own adult children when they were 24 and 26 and my husband and I were going out of the country on vacation,” says Warshaw. “They were very emotional and crying and didn’t want to talk about it, but I explained to them that we were giving them a gift, so they would never have any questions about what we wanted.” If you suspect mentioning the word death will be difficult for them, frame it as about making health care decisions for you if you’re unable to do so.

Be prepared for pushback

Sometimes, your loved ones may disagree with your health care decisions. Be patient. They may just need some time to accept the idea. Reassure them that you yourself may change your mind, and you can revisit the topic if need be. Remember, this is just the first conversation—not the only one. You can have as many conversations as you need with your loved ones until you all feel comfortable.

Pick a health care proxy

This is the person you choose to make health care decisions for you if you become too sick to make them yourself. It’s particularly important if you’re 65 or older, as half of people in this age group admitted to a hospital are unable to make health care decisions themselves, one study foundA health care proxy is allowed to speak with your doctors and make choices about what treatments you should have.

It’s important to choose someone that you trust to honor your end-of-life wishes, even if those wishes are different from their own. It’s okay not to choose a family member, but just be sure to explain to your relative why before they’re faced with a medical crisis. You’ll also want to complete an advance directive, a legal document where you state your wishes regarding end-of-life care. This can help guide your doctors and your health care proxy. Find all the forms you need, including health care proxy forms, here:

Talk about your funeral wishes, too

Do you want to be buried? Cremated? Will you want your casket to be bedecked with flowers, or do you want something simpler? Where do you want memorial gifts to go? How would you like to be dressed? What songs would you like to be sung? Who would you like to give a tribute? Your loved ones may cringe when you bring it up but they’ll be thankful to have that information later, when planning your funeral is a reality.

If the topic just seems too uncomfortable, consider broaching it over dinner—literally. The website Death Over Dinner was launched two years ago and offers advice on how to throw an intimate dinner party where you can have these very conversations. Remember—your funeral is your last party here on earth. You have a right to make it count.

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