How to make end-of-life planning less stressful
Recently I hosted a strange family gathering: an end-of-life luncheon.
It was my sister Dinah’s idea. She had been saying for months that it was time to discuss my parents’ final wishes, while both of them could still weigh in.
But I kept putting off the conversation. Who wants to think about it, whether it’s your own death or the death of someone you care about?
Research shows that less than a third of US residents have advanced care directives or detailed medical instructions in case they cannot communicate their own wishes. Without such instructions, loved ones are left using guesswork, which can be confusing and chaotic.
So I overcame my reluctance and invited the family to talk about everything from their stances on resuscitation and funeral plans to who will take their cats. I even tried to make it festive by ordering pizza and baking a chocolate cake.
I’ve learned things about my family that I never knew: My mom and dad don’t want a memorial service. (“We don’t like large gatherings, living or dead,” my mother explained.) My sister Heather, meanwhile, wants hers to be held at Starbucks. (A Starbucks representative said that while this was “definitely a unique question that we don’t often see on our desks,” they declined to comment further.)
Our lunch was occasionally strange – my father once read that you can press “cremains” into a working vinyl record, and he briefly floated the idea – but the meeting was not as sad or awkward as I had imagined. Instead, it was a relief to talk openly about my parents’ end-of-life wishes, rather than repeatedly burying them.
If you’ve been putting off these discussions, here’s how to get started.
Schedule a conversation.
First, ask your family members if they would be open to a family meeting – in person or via Zoom – and then set a date.
If you need a conversation starter, Mirnova Ceide, associate professor of geriatric psychiatry and geriatrics at Albert Einstein College of Medicine, suggested bringing up a news story about dementia. “You can say, ‘This has made me think about how important it is for us to talk about these issues now,’” she said.
If you’re the older family member, consider hosting the family meeting yourself, suggested Alua Arthur, an end-of-life doula and the author of the upcoming book “Briefly Perfectly Human.”
It may feel awkward to broach the subject, she explained, but you can consider getting your affairs in order as a posthumous gift to your family.
You’ll save them from a scenario “where they’re in the middle of a huge grief, and then they’re also trying to figure out what to do with all your stuff and where to find your passwords and everything else,” Arthur said.
Prepare a checklist.
Create a document that the whole family can access, and put together a checklist of topics and prompts to review, said Dr. Ceide. A good source for questions, she said, is the end-of-life guidelines from the National Institute on Aging.
The two crucial things to discuss at the first meeting, said Dr. Ceide, are who will serve as your health care proxy, as your surrogate for health care decisions, and what guidelines should be in your living will.
“We cannot control the timing and nature of our death,” added Diane Meier, professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai. “You cannot predict exactly what the conditions will be like. So the most important thing to do is appoint someone you trust who can speak on your behalf if you are unable to speak for yourself when decisions need to be made.”
The institute also has a list of ways draw up advance directives for little or no cost. (And Medicare covers advance care planning as part of your annual wellness visit.)
Once you’ve decided on your health care proxy and created a living will, you can make it official by completing a durable power of attorney for health care, a legal document that lists your health care power of attorney. Then distribute copies to your doctor, loved ones, and, if you have one, an attorney. (A lawyer is useful, but according to the institute not mandatory.)
Provide reflection.
Our family had a long conversation about how my parents wanted to spend their remaining years. Arthur, the doula, suggested asking: What is still undone in your life? “Because that helps you figure out where you want to spend your time and energy,” she said.
We discussed the things our parents still wanted to do, and how we could make them happen. My parents said they were hoping to travel more locally. My dad wants to attend his 65th high school reunion in Michigan (“at my age they do that every five years”). Dinah, my sister, said she would accompany him.
Another useful resource is the Stanford Letter Projecta free website that offers tools and templates for writing a “last letter,” a personal message of gratitude, forgiveness, or regret that you can share with the people you love.
Consider checking in regularly.
End-of-life care is probably too big a topic to solve in one meeting, said Dr. Ceide. She encourages families to have a regular conference call to check in.
Doing this can help you get on the same page so you’re all aware of and planning for issues like purchasing a driveway for your parents’ house, explained Dr. Ced out. You are able to “address small things as they come, so that when the bigger issues arise, you already have the infrastructure and reassurance to communicate about these things together.”
After our meeting, my father asked me to pack a piece of chocolate cake to take home. “After all this talk of death, I should probably seize the day,” he said.
These are the 5 most feared exercises according to trainers.
Some movements are easy, some are tough but doable, but there are a few that people really hate (like burpees). Although you may be tempted to skip them altogether, there is a way to make them work for you.
Read the article: 5 exercises we hate, and why you should do them anyway
Symptoms of high blood pressure can be difficult to recognize. Here’s what you need to know.
Nearly half of American adults have high blood pressure, “a smoldering health crisis,” one expert calls it. High blood pressure can increase the risk of heart attack and stroke, but the symptoms are often silent. Here’s how to get high blood pressure under control.
Read the article: Why high blood pressure is important for your health
The week in Well
Here are some stories you won’t want to miss:
Let’s keep the conversation going. Follow closely Instagram, or write to us at well_newsletter@nytimes.com. And check out last week’s newsletter on how to recognize hearing loss as you age.