The Conversation: It’s That Time of Year Again

Every fall, in time for your Thanksgiving plans, we remind you that it’s time for The Conversation. No, not that conversation — we assume that the fact that you have grandchildren means you’ve already navigated that one. We’re talking about the end-of-life conversation.

Why this time of year?

Because your far-flung family is likely to be in town for some of the upcoming holidays. It gets dark earlier (not that the conversation needs to be dark). And there’s that big block of time after the game, before dinner and while the cook recalibrates how long it actually takes to cook a turkey.

Seriously (and this is serious) — you need to have the conversation with your family and involved friends. Don’t assume that they know what you would want. Assume that they are eager to know — but they don’t know how to broach the topic with you.

Maybe you’ve had a recent death in your family. Perhaps there have been opportunities to think (and talk) through your views on the end of life. But don’t assume “I would never want to live this way” is a sufficient explanation of your thinking.

I’ve had the conversation with the one person who needs to know

Great! You’re an outlier, and we applaud you. But you’re not done.

You need to have the conversation with all of your family. Not just the daughter you’ve named as health care agent, but also with the son who is adamantly opposed to removing life-sustaining treatment. And the other daughter who assumes that she will be the one to make the decisions.

Why? Because when it comes time to implement your instructions, you don’t want your health care agent to ever hear the phrase “I don’t believe mom would ever choose to die” or “if this is what dad really wanted, why did he never mention it to us?”

And here’s a harsh reality: if there is dissension in your family, that greatly increases the odds that you will be kept alive beyond the time you would have wanted. Plus you make your chosen agent’s job that much harder.

Can’t I just fill out all the right forms?

Great idea! Yes, you should do that. If you are an Arizonan, or spend a lot of time in Arizona, we think you need at least a health care power of attorney. In fact, it might turn out to be the single most important document you sign as part of your estate planning.

But it doesn’t end there. You also probably want to have completed a living will (it might be embedded in your health care power of attorney). In Arizona, you can also have signed a mental health care power of attorney. And there are innumerable tools to help you both sharpen your thinking about end of life, and to communicate that thinking to your agent (and family). We are fond, for instance, of the Five Wishes approach — it helps you by asking questions about specific scenarios and it encourages discussion.

But be thoughtful about signing the forms you see online (including the Five Wishes project’s form). They can undo the planning you thought out with our help, and they might create disputes about who is in charge. So we say work through the questions, but don’s sign the form — consult with a qualified attorney about how to integrate the issues into your estate planning. And please don’t just default to the Arizona statutory form — it skips too many of the important discussion points and gives your agent less authority than you probably want to give them.

When I bring it up my kids say they don’t want to talk about it

Who’s the parent here? You need to have the conversation. They need to engage with you.

It needn’t be a long conversation. Maybe start with explaining who is named as your health care agent and what documents you have signed. Consider sharing copies of the health care documents (and emailing or mailing to those family members not at dinner that day). Invite questions or conversation — but not really argument. Make it clear that this is serious, and you expect your wishes to be honored.

If you have particular things you feel strongly about (CPR, or dialysis, or blood transfusions, or whatever you particularly want or want to reject), explain that and maybe why. Those items are good to include in the documents, too — but it is even more important that your family know your wishes.

Thanks, I’ll do it. But I need more help

Good news! There’s a resource set up to help with this precise issue.

It’s called The Conversation Project, and (no surprise here) it has a robust website and some guidance and suggestions. Their Starter Guide is, well, a good conversation starter.

So schedule the conversation for this upcoming holiday season. And Happy Holidays. And pass the drumstick, please.