When is the Time to Talk About Stuff That's Hard to Talk About?

A few years ago Bill Moyers created an excellent program that focused on how our culture responds to people at the end of life, often making the quality of death a lower priority than the quality of life. With that program and a few others, there is finally emerging the very beginnings of the willingness to look at what has been a taboo topic. But if we don't embrace the end of life with love when our parents and friends are dying, who will there be to teach our children and friends to comfort us with love when we, too, must approach our own end?

In other words, can our society learn to face the reality of human mortality and provide greater support for a dignified death? Moyers asks, "How can we built a system that will help us tackle the social, financial, spiritual, and physical challenges of dying so that we can have confidence that our experience of it will be on our terms and will reflect the values we hold most dear?"

I believe we can change our way of looking at death the same way we have been able to affect change for many problems in society — one family and one person at a time. I hope I will be an agent of change. Will you?

We can begin by being willing to talk about topics that are often hard for both children and parents to initiate. Yet these discussions can smooth out the rough spots associated with the dying process. And here are some of the things you can talk about, according to a good friend of mine who is the chaplain in a retirement community.

• Talk, talk, talk about what you want done at the end of life, especially when you are incapacitated. For example, what does "life support" mean to you? Hospitals love feeding tubes and if you don't want a feeding tube, be clear about it.
• Be sure to sign a document, such as Five Wishes [http://www.support4change.com/health/special/wishes/wishes-1.html], and let your family know where you keep the paper.
• Since older parents often don't question the orders of a doctor, even though they would like something different, be sure you know what your parents really want and make sure others know what you want.
• Remember that a Durable Power of Attorney may be seen as having precedent over a Durable Power of Health Care, so be certain the person to whom you give the rights to make legal and financial decisions is someone who agrees with your views on medical issues.
• If you have a "do not resuscitate" card or other information about your durable power of health care, carry that card with you at all times. You never know when you may need it. Keep this important information behind the driver's license because paramedics will look there.

In the magazine Aging and Spirituality, Rev. Donna Schaper wrote an article entitled, "Parents and Children: The Last, Best Gift." This "gift" is the willingness of parents to discuss with their grown children topics that have often been taboo, often for no other reason than that they are simply uncomfortable. But as she points out, discussions about money, estate planning, and health care can either be done when it is convenient and the decision-making process can be collaborative, or when parents are feeble and ailing, time has run out, and children are scrambling to pull together pieces of information that are hard to uncover.

Jung said that we ourselves should become whatever we want our children to become, a statement that summed up his ideas on child-rearing. If parents want children to become fully mature adults, parents themselves need to be fully mature adults throughout their lives — including in their final years when, predictably, their health will fail and they will die.

Parents who give the gift of final preparations and directions to their children give a gift beyond those of childhood. Parents who take charge of their own aging and dying will produce children who can do the same. When we take care of ourselves, we prepare the way for others to take care of themselves. That kind of care is adult. It is mature. It is the kind of care that the ancient sage Maimonides referred to when he decreed nine ethical laws, in descending order of importance. The first law? Take care of yourself so as not to become a burden to others.

What happens when parents wait until their health fails before making decisions that must be made by someone? At the very least, they force their children to make difficult decisions that are not the children's sole responsibility. However, in making those decisions, children may unintentionally decide to do something the parents would not have wanted.

Further, making decisions early is especially critical when without the specific instructions from the parents, siblings resurrect their old rivalries in the process of trying to sort out their parents' wishes. The quarrels that result from an estranged child suddenly coming in to demand certain "rights" (including the right to continue medical interventions beyond the time his siblings believe the parent would have wanted, to say nothing of demanding certain possessions) can go on for years after the parent's death.

Is that what you want as a legacy? How much better to talk now with calm deliberation about what is in your will, how you want your possessions distributed, how you've planned your estate to avoid taxation, whom you'd like notified in case of illness or death and how, what will happen if one parent precedes another in death, and what you'd like done for a funeral, burial or cremation. Most of all, by talking about "delicate" subjects now, you can collaborate with your children and get their input, demonstrating your willingness to encompass their wishes, including those of estranged children if possible.

Just as love was the gift you gave your children when you brought them into the world, love can be a vital part of leaving them when the end of your life draws near.

©2002, Arlene Harder, MA, MFT