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Palliative Care Center

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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

Benefits of Advance Directives continued...

But talking about an advance directive doesn't have to be so difficult, says David Casarett, MD, associate professor of medicine at the University of Pennsylvania and chief medical officer at Penn's hospice and palliative care program.

"If you think about advance directives as being all about death and dying and the final days, then it's really difficult," he says. "If you think about them the way they're intended -- which is if a family member ever gets to the point where they're not able to make decisions for themselves for any reason and they have a serious illness -- advance directives are really all about helping the family to come together and do the right thing."

"Framed in that light, in my experience, a lot of people are not only willing, but enthusiastic about doing advance directives," Casarett says. "It helps to make sure a family comes together and doesn't wind up arguing or disagreeing -- framing advance directives as doing something for their family, rather than for themselves."

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?"

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