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Advance Directives: Having the Talk

How to Talk to a Loved One About Making a Living Will and Durable Power of Attorney for Health Care

Start the Discussion

Advance directives aren't just for the sick or elderly. So don't wait until a loved one has been diagnosed with a terminal illness to start talking about advance directives.

Life can change in an instant. Someone might have a massive stroke or serious accident, for example. So don't wait until a loved one has been diagnosed with a terminal illness to start talking about advance directives.

"Having a discussion well in advance of a crisis just gives lots of opportunity for clarification or mutual understanding," says Kathy Brandt, senior vice president in the office of education and engagement at the National Hospice and Palliative Care Organization. That way, there's time to understand why a loved one has made certain choices, how he or she reached those decisions, and what values and beliefs informed them, she says.   

Having the Talk

Look for graceful ways to introduce an advance directive:

The experiences of others: If a relative or friend has been gravely ill or has died recently, it may open the door to a discussion, Storey says. Besides asking a loved one what he or she would have wanted in that situation, Storey also suggests saying, "I really want to do a good job of representing what you would want in situations like that. Have you thought about that?"

If there's no personal experience to draw from, you can point to cases that have been in the news, Brandt says.

Seeing others go through great turmoil may spur some people to write an advance directive to ensure that they don't spend a long time on life support machines or cause more distress to their families. 

Transition points in life: Any plans for the future -- such as a loved one's retirement, a move to an assisted living residence, the writing or updating of a will -- are natural ways to open the conversation. "Any kinds of life events can all be triggers for conversations about these issues," Brandt says.   

Set an example: Set up your own advance directives (anyone aged 18 or older can make them). Then tell your loved one about it and ask if he or she would like to do the same.

Making an Advance Directive

A family discussion on advance directives has strong value, but make sure to capture the wishes on paper, Casarett says.

Relying on memory can be tricky, and siblings may disagree on exactly what Mom or Dad told them during numerous discussions.

All states have their own advance directive forms, which can be found online. They don't require an attorney to fill them out, although some people do leave a copy with their family lawyer.

In a living will, the main goal is to help a loved one express how much medical intervention he or she wants. Casarett suggests starting the conversation generally by asking about the kinds of treatments wanted if your loved one was very sick, unable to recognize family, unable to take care of himself or herself, or unlikely to get better.

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