Using Living Wills to Start the (Other) Tough Conversation With Mom and Dad
We have all heard parents fret about answering their children's questions about where babies come from. Responses to the daunting “how does life begin” inquiry range from evasive stories about birds and bees, to the time-honored “ask your mother,” or these days, “ask your other mother.”
February 05, 2018 at 10:45 AM
5 minute read
We have all heard parents fret about answering their children's questions about where babies come from. Responses to the daunting “how does life begin” inquiry range from evasive stories about birds and bees, to the time-honored “ask your mother,” or these days, “ask your other mother.”
Less storied, but equally important, is the question parents ask children at the other end of the life cycle, namely, “can we discuss the end of my life?” and more pointedly, “will you help me close my final chapter?”
Adult children often address these uncomfortable queries with the same evasion they experienced when they asked how babies were made. Some duck the issue with responses like “you're too healthy to discuss this,” while others refuse to discuss it at all.
As many have learned the hard way, in the end of life context, a conversation delayed can be a conversation denied. Parents fall ill and lose their capacity to think about—let alone talk about—their final wishes. Silence can be a dangerous gambit.
In Florida, you can break the silence by raising the possibility of signing a living will—a document that memorializes a person's end of life wishes, and can speak for him when he can no longer speak for himself. Living wills declare that the signator wishes to withhold or withdraw life prolonging procedures under enumerated circumstances permitted by statute, and is typically accompanied by a form that designates a “surrogate” to carry out those wishes.
Although living wills play an important role in our legal and medical system, in my view, they too often replace—rather than prompt—sorely needed conversations among loved ones. Without these important exchanges, the living will often provides more legal cover than emotional comfort, and forces children to plot their parent's final course based on a legal form filled with check marks next to phrases like “end stage” and “persistent vegetative state,” followed by a shaky signature that barely resembles the one that signed their report card. Children already enveloped in grief are left wondering if their mom truly understood what she signed, or if dad really wanted to go gently into that good night.
As anyone who has been through it will tell you, the decision to help a parent make her chosen exit presents a painful and confusing sea change. Until that moment, the family has been a united team, focused on fighting to keep mom alive, and the miniscule daily developments that keep hope alive. That all changes, however, once the family decides that continuing the fight is futile, and that it is time to transition from traditional medical care to hospice, or comfort care.
It is at this pivotal juncture that being able to reflect on the discussions you had with your parent matters most. No check mark on a printed page can replace the memory of a parent telling you how and why he wishes to live—or not live—in his own voice.
If you haven't done so, ask your parents if they have thought about a living will; they will probably welcome the inquiry. Most parents want to avoid being a physical or financial burden on their children, and have thought about what makes life worth living—and not living. If a parent balks, consider telling him that you need some guidance just in case, and ask if he is willing to discuss a living will with a trusted physician, cleric or counsel.
I find that parents take comfort in talking about end of life planning, and that the prospect of signing a living will can provide context and structure to a sensitive conversation. Although the discussion can be difficult, it can also be enriching, and include uplifting visions of what gives life meaning—reflections that can put artificially prolonging life in sharp relief.
Although talking to your parent before he signs a living will may not ease your grief, it may provide clarity and comfort to both of you in his final days. Indeed, if a parent has expressed his end of life wishes, your efforts to fulfill them becomes your sacred mission—rather than a failure or defeat.
Your mom may have stammered when you asked where babies came from a lifetime ago, but she probably has a lot to say about how she has lived her life, and when she would choose not to artificially prolong it. So please, start the conversation. You'll be glad you did.
Pam Perry is a lawyer and mediator. Her practice includes assisting hospitals, families and individuals in connection with end of life issues.
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