How to Talk to a Senior About End-of-Life Concerns

Some of the most critical conversations are also the hardest to hold, especially for caregivers. Areas like finances, end-of-life, health care, sex and independence are all extremely important. But, they’re never easy.

This pattern becomes worse if the relationship between you and your caree is strained, or if they’re stubborn.

Previous posts have talked about how to get started with advance planning, along with what you can expect. In this piece, we’re looking at how you can begin those conversations.

Be Sensitive

Difficult topics should always be approached with care. These are emotional areas, ones that can promote a myriad of reactions, in your loved one and in yourself.

Talking about them involves paying close attention to the way that the senior responds and the areas where they feel uncomfortable. You may also be able to find ways to lessen the discomfort, such as having the conversations in little bits at a time or being prepared beforehand.

One key aspect is being aware of the reasons for any resistance. Some areas include the following:

• Fear of making the wrong decision or saying the wrong thing
• Fear of the unknown
• Concern that appearing weak may make life more difficult. This is especially true for seniors who still live in their homes and do not want to move into assisted living of any form.
• Stress, strife or conflict within the family
• Denial
• The presence of secrets that they do not wish to share
• Simply not being used to talking about emotions and/or have no interest in doing so
• Not knowing who to trust. This can be particularly significant for anyone who has had their trust broken in the past.

Understanding these areas can help you figure out a way forward. For example, denial and not knowing who to trust may both present with the senior being unwilling to talk. But, the situations may be resolved very differently to one another.

The site Dying Matters also highlights key ways that you can broach the topics, as well as how you can respond. Some key takeaways from their piece are the following:

• Be respectful. You don’t have to agree with what the other person wants to do and their wishes may not even be feasible. But, you do still need to be respectful and understand that this is ultimately about their desires, not your own.
• Be calm and collected. As much as possible, try to retain a level head. End-of-life topics are challenging and they are immensely emotional. But, you need to be the one to guide the conversation, which may sometimes mean not giving into your emotions.
• Focus on leading questions. End-of-life is a large topic and it is complicated. The idea of simply talking about it often won’t be enough, the senior simply won’t know where to begin. Leading questions are a powerful way to guide the conversation without being overwhelming.
• Stay engaged. Use conversation tools like eye contact and body language to ensure that the senior knows you are interested and are listening to what they have to say.
• Provide comfort. Comfort can come in many forms and the best approach may vary depending on your family member. But, short comforting statements (like ‘I’m here for you’) and the touch of a hand are powerful approaches that can make the process much easier.

Talk About Why

Talking about end-of-life issues is critical. The topic is very relevant to the senior and also to the people who will be left behind.

Some of this won’t be obvious to the senior. This is particularly true if they don’t know much about the end-of-life approaches that you are talking about.

This means that it’s critical to talk about why you are proposing these areas and their implications. Some seniors may be unwilling to make decisions for their own benefit but more than ready to do so to make life easier for their family.

The site Real Simple a great guide to these areas, highlighting various important topics, why they are relevant and how you can bring them up. The article even offers information about how you can get started with the processes.

Be Willing to Step Back

End-of-life conversations take time. You may simply need to introduce the topic and wait for the senior to be ready and willing to talk about it.

Many will need time to come to grips with the idea and figure out what they actually want. Doing this is often easier when another person is not involved.

From a caregiver’s perspective, this may mean that you need to step back and wait.

Rely on Tools or Guides

You don’t have to have these conversations based on your own instincts alone. There are many products and services out there that can step you through the process.

For example, some guides will highlight key questions that you can ask and areas that need to be talked about. They might even give you lead in questions and ideas about how to broach a particularly difficult topic.

Two powerful examples are The Conversation Project and PREPARE.

Both are designed to make end-of-life conversations easy, especially for people who don’t know where to begin.

The Conversation Project also features a Conversation Starter Kit, which can be viewed online or printed. This kit provides a step-by-step approach for addressing this complex topic, along with places for you to write down information as you go.

Many of the sections are easy to fill in, asking for answers on a scale of 1 to 4. This helps to make the topic much less overwhelming and easier to follow.

Even if you don’t plan on using a formal guide, we recommend checking out the kit. It may give you ideas about how to tackle the topics and what angles you can consider.

Consider Spiritual Support

End-of-life is often the time where people start to ask questions and want to learn more about faith. It’s important to provide support here and to facilitate whatever concerns your family member may have.

This could involve getting a local pastor involved. A chaplain in a hospital or palliative care environment will often have the ability to contact people from other faiths and provide support.

Of course, not everyone will want spiritual support. You need to find the balance that works best for the person in your life, in relation to their wants and needs (not your own).

Final Thoughts

End-of-life conversations are hard. It doesn’t matter how prepared you are, the process can be draining and often frustrating.

You may also be fighting an uphill battle, especially if your family member is uncomfortable talking about the topic. This could even mean you never get the answers that you want.

And honestly, that’s okay. At the end of the day, this area is all about the senior and their wishes. If their wishes are mostly not to think and talk about end-of-life, then that may simply be how things have to go.