Having difficult conversations

Hard (but necessary) conversations to have with loved ones

What do we need to talk about?

You need to talk about what type of medical treatments you want – or don’t want – if you were to become seriously ill and not be able to speak for yourself.

And, you need to plan ahead for, and talk frankly about, practical matters surrounding your own death.

Why do we have to talk about these things?

If you don’t take the time to think about and decide what you want to happen to you medically at a time when you are seriously ill, then someone else will decide, based on local laws.

This could result in a bad experience for you, and for your loved ones.

If you don’t take the time to think about what happens after you die, the courts will decide what happens to your possessions. And you will leave a huge burden on your grieving loved ones.

So, make the time to think about what you want – and to discuss things with your family or close friends.

Do it now, rather than in the midst of a crisis.

What do we talk about?

Start with some frank medical discussions. Talk about what you would consider “quality of life.” Think about who might be able to take care of you if you are no longer healthy.

Discuss who you would want to make decisions for you if you are not able to make them for yourself.

Research the pros and cons of various treatments offered at the end of life. There are treatments that can extend life, such as CPR, feeding tubes, and ventilators that help you breathe. There are treatments that are considered palliative, or which focus on comfort, and involve the use of medications to control pain and other symptoms that might be experienced when you are dying. These are topics that can be discussed with your physician or other health care professional. It is important to be informed when making these important decisions because the issues are so complex.

If you belong to a particular faith, consider researching your religion’s teaching on end-of-life issues.

Also, talk with your loved ones about what you want to happen after you die. What type of funeral would you like? What would you like done with your body? What type of life do you envision for your family? How would you like to be remembered? What would you like to happen to your money? To your possessions?

How to have these conversations

Work to find a way that is comfortable for your family. For some it may work to schedule a family meeting. Others may be more comfortable with one-on-one conversations.

Consider having a professional facilitate the discussion. Perhaps a counselor or faith leader could help get it started. You may want to call on the expertise of a health care professional, financial planner or lawyer.

Have several conversations; you may need time to think over these difficult subjects.

Write down your wishes.

Research and then create the necessary legal documents.

Discuss your financial assets and estate planning and distribution of your possessions with a lawyer and a financial planner.

Making decisions about medical treatments that you would want or not want is called advance care planning. You can document your wishes using advance directives.

Write everything down to maximize your chances of having the medical care that you want.


Continue to have conversations and be conscientious about updating the legal documents as your thoughts evolve, you gain new experiences or your circumstances change. Revisit your decisions every year or two.

Take some control.

Give this gift to your loved ones.

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