One family may find it hard to talk about sensitive topics, such as politics or money, while another family may approach these issues with ease. All families, however, can be overwhelmed by a topic that everyone needs to consider: The End-Of- Life
Discussing End-Of-Life issues ahead of time gives strength and knowledge to a person with a terminal illness. It enables them to be an advocate for themselves and express how they want to die.
Waiting too long to have these conversations will leave families to make tough decisions without knowing what the person wanted. Too many people do not express their wishes early enough to be able to die the way they want.
Some of the key topics that need to be discussed during End-Of-Life conversations include:
An individual can achieve their desires only if they are willing to communicate them. They should discuss their desires with someone they feel they can talk to openly. This person may be a family member, a doctor, a palliative care team member, or a spiritual or religious advisor.
Cultural factors can play a large part in influencing decision-making at the end of life. For example, some cultures feel that informing someone of a serious, life-threatening illness is disrespectful and inhumane. Some cultures feel that clinicians should remain optimistic and not reveal a terminal diagnosis. They also feel that the use of negative words about health may be self-fulfilling.
Some cultures feel that family members should be doing the decision-making while others leave it all up to the physicians.
It is part of many cultures for the eldest son to make decisions for the parent’s healthcare. In some cultures, survival alone may show significant spiritual faith. However, never assume that all individuals from a culture hold the same values; instead, assess everyone’s cultural influences.
Cultural differences are another reason that initiating conversations about advance directives before people need them should be the goal. An advance directive is a legal document that states a person’s wishes about receiving medical care if that person is no longer able to make medical decisions because of a serious illness or injury.
How do you start a conversation about the end of life? Many things or events can be opportunities to begin these conversations. You must learn to recognize them. Heart- to- Heart has developed a “Starter Kit” to help families talk about the end of life and prepare for what is to come. You can find a link to this in the resources section.
There is no “right choice” in these conversations. The purpose of the conversation is to learn what everyone’s individual thoughts are and to understand their desires. Never assume what someone else might want or need.
Decisions about the end of life should be discussed before a health crisis occurs. The person, their family, and their caregivers will have an easier and more valuable conversation if a crisis, such as impending death, does not rush them. These conversations are difficult, but they add insight and calm fears about death.
Conversations before a crisis will also aid the family in coping with their loss. Preparing for death helps the surviving family members move through the healing process. Although it is still painful, the process is easier for the family members if they have a chance to communicate throughout the process.
Meaningful conversations also give peace and comfort at the end of a person’s life. Having a plan allows all people involved to focus on what is important, making the end of life meaningful and memorable.
Conversations about the end of life need to take place at the appropriate time and in the appropriate place. It is best to initiate the conversations as early as possible and before a health crisis happens.
Maintaining open and honest communication is a priority in end-of life care. People want to have time to plan and complete their life. Establishing a trusting relationship is key to open communication.
Family life revolves around communication, particularly talking. Talking allows us to build meaningful family relationships. These conversations can convey expressions of love and caring, but at times they can relay anger and hurt.
One of the best ways to advise families to approach this topic is to use a related event or discussion as a starting point. Related events or discussions are cues for conversations about the end of life. These may include the following:
The death of a relative or friend is sad, but it is a good starting point to explore views regarding the end of life. During these conversations, close family members may discover that they hold opposite views. These views may differ on fundamental end-of-life issues, such as the quality of life.
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