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    Understanding Your Health Choices: Conversations Before the Crisis

    Happy occasions and family memories

    Birthdays and anniversaries are times when families reconnect, and present good opportunities to emphasize the family ties. Part of preparing for the end of life is valuing what has gone before. We treasure what we have in part because we will not always have it.

    Joshua and Rachel celebrate their grandparents

    Joshua and Rachel are 10 and 12 years old, and are close to their maternal grandparents. On the occasion of the grandparents' 40th wedding anniversary, the children made a book telling about some of the special things their grandparents had done for them over the years, including photographs and drawings. They presented this at the party, with friends and family present.

    Honoring their grandparents, they gave everyone an opportunity to talk about what mattered to them as a family. The events they selected for the book-special talks with their grandfather, the meals their grandmother cooked when they visited, and the fact that their grandparents took them to museums - emphasized that in this family each generation shared a tradition of nurturing and education. It gave Rachel and Joshua a chance to realize that their grandparents will not always be with them in person, but will be there in memory and spirit.

    This kind of activity goes beyond sentimentality. It says that each generation has a role to play. Events like this offer a good time to talk about what is most important to us. Honoring the past helps us to prepare for letting go. And it paves the way for conversations.

    Reflecting on a life

    When someone dies, the sense of loss is intense but hearts are open. Funerals and memorial services help everyone to understand what the missing family member meant. They are remembered from the smallest (perhaps most annoying) trait to their largest career success or civic achievement. At this time, everyone in the family reflects, either consciously or unconsciously, on how they knew and loved this person, and how the deceased fit into the family.

    After a funeral or memorial service, families are often together, and this is an excellent opportunity for candid discussions about the end of life. Was this death planned for in some way? What lessons were learned? Is the family comfortable with the medical treatments and burial arrangements? For families this is a very special time and opportunity. Tears and open emotions can lead to clarity, honesty and a true celebration of life.

    After the funeral of her uncle, who died peacefully at 93, Sara sees an opportunity to talk with her mother. "This reminds me of when Grandpa died, and of how you took care of him at home for so long. That must have been hard, and I know it was difficult for you and your brothers to decide what to do. I know you wanted to care for him, but you had to give up your own plans for those years. I really admire what you did. If that happened again today, do you think you would make the same choices? Is it best to care for a dying person at home?

    WebMD Medical Reference from the National Hospice and Palliative Care Organization

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