Understanding Your Health Choices: Conversations Before the Crisis
A difficult conversation between father and son
Steven brings up the subject of death.
Dad," he says. "I've been thinking about the end of life lately, the
end of my life. I know it sounds weird. Nothing is wrong. But a friend of mine
at work had a terminal illness and his family didn't know what he wanted. The
family disagreed about what to do, if he should be put on a ventilator and
other stuff, and it made the whole thing so much harder. I don't want that to
happen if I should suddenly be in that situation."
Spiritual and religious well-being may help improve quality of life.
It is not known for sure how spirituality and religion are related to health. Some studies show that spiritual or religious beliefs and practices create a positive mental attitude that may help a patient feel better and improve the well-being of family caregivers. Spiritual and religious well-being may help improve health and quality of life in the following ways:
Decrease anxiety, depression, anger, and discomfort.
"Let's not talk about this now," his father says. "You're
healthy and young, and nothing bad is going to happen to you. Besides, if we
talk about it, it could come true."
"Talking about difficult things does not make them happen. Since Deborah
is my wife she'd have the legal responsibility to decide, but I would want you
and Mom to understand and help her. And to be able to explain to the kids that
this is the way I wanted it."
"So tell Deborah, but don't tell me. I don't want to know."
The conversation has begun. Steven and Deborah begin their own conversation
and complete their advance medical directives. A few months after the first
conversation, Steven gives his father a copy of his plans.
"Dad, I know that you don't want to talk about this, but Deborah and I
have agreed on what we each want, and have written it down. My doctor has a
copy. I want you to know that I plan to be conscious and able to communicate as
long as possible, while Deborah is worried about pain and would prefer to be
sedated, even if it means being out of touch. Which do you think you would
"I don't want to choose. I want to die in my sleep."
"Well, that may happen, but you can't be sure of that."
This may be as far as Steven can go right now. But it is a good bet that at
some point, one of his parents will raise it with the other. Over time, Steven
can use current events and family happenings to restate his concern. And Steven
and Deborah are clear about their choices, and have informed their doctor.
There is another benefit. Steven purposely had these discussions in the
hearing of his teenage children. He did not ask them to participate, but later,
when his daughter asked why he insisted on bringing this up, he said, "I
love my parents and I want to care for them, just as I want to take care of
you. Dad and I don't agree on much, and what I would choose may not be what he
would want. But this is part of what we need to do as a family. If you have any
questions about these things, I hope you will ask your mother or me."
WebMD Medical Reference from the National Hospice and Palliative Care Organization