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    Conversations Before The Crisis

    It's not just logistics

    In addition to understanding what treatment choices a person wants, and who is going to make those choices, conversations about the end of life-because they are difficult-are also opportunities to explore family issues. The job of the adult child and the aging parent is to heal and appreciate their relationship, to acknowledge love and caring.

    It is often easier to give help than to take it. When adults refuse help, it may be because they have long been givers, not takers. They do not want to be a burden. This can apply to advice and conversation as well as care in the home help with travel, etc. Adult children need to respect the dignity and privacy of their parents. But it can be a gift-a created state of grace-if they allow or accept help.

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    It is important to think through why you want to have this discussion. Here are some good reasons, incorporated into conversation.

    "Dad, you know I've mentioned some things about the end of life, and that I've wanted to talk with you more about this. I want to be sure you understand why. We never know what is going to happen and you could outlive me, but if you are very sick I want to take the best care of you that I can, and I want to respect your wishes. Over many years you and I have worked hard to understand each other, even though we've had differences. I don't want to make any assumptions about what you want. I want to make sure your wishes are honored. So I would be grateful if we could talk about this-not in so much detail-but just in general."

    "Richard, as your sister I've seen you operate on your own for years, and I know it's important to you to make your own decisions. Control means a lot to you-I guess it runs in the family. I'm like that myself, as you know better than anyone. Now that I've turned 50, I've realized that I'm possibly, just possibly, not going to live forever, and I want to ask you to assume responsibility for me by naming you on my advance directive. But since we are both so strong-minded, I'd like to tell you what I think I would want, and I'd like to know your thoughts. I appreciate your counsel, and I trust you. So could we talk about this?"

    "Mom, I have watched you care for people all your life. You are a born caregiver. But someday you may need some care yourself. It would mean so much to me to be able to help you, and help you decide about things as our lives change, and I'd like to start now by asking you a few questions. Could we do this?"

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