When And How to Begin a Conversation about End of Life Planning with Older Parents

One question I hear often when I am speaking with groups of people is “How do I bring up the subject of my parents’ plans for the end of their life?” It is not an easy question, nor is the answer a simple one, as it depends on the willingness of one’s parents to even discuss such issues, and also on the relationship they have with their children.

No one likes to spend time contemplating his or her death. But there are ways to begin a series of conversations that might take place over many months, depending on their willingness to open up.

“Have you and Dad made any arrangements with a funeral home or cemetery? If you die, we want to know what your wishes are, and that you have written this down for us.” That can also lead into a discussion on the relative pros and cons of burial versus cremation, and related costs.

A less direct approach might be to raise it after they have been to a funeral of a good friend.  Parents often let their children know when a friend has passed away, as the children likely know that person well. It is a good opening to ask about the funeral, who spoke, was there a celebration of life afterwards, etc. This can easily lead to the questions of “Have you and Dad thought about what you want?”

If you are in your 40’s, and nothing has yet been said, try to start a conversation…“I know you guys are healthy, but just in case something were to happen that put you in the hospital, we need to know that you have made some arrangements.”

At some point as they age, and you are likely in your 50’s or even your 60’s, you will need more specific information. I think it is easier to address in stages, starting with knowing their medical history, prescriptions and doctors. Past the age of 60, the great majority of people have been given some indication that there could be a problem in the future, due to high blood pressure, cholesterol numbers outside the desired range, and perhaps even diagnosed with diabetes or some other cause for concern which will lead to problems down the road. You can start the conversation by asking if they have this information written down, in case you need to help them at some future point. If you volunteer to help them put this together in one place, they are even more likely to agree to do this, and then you would only need to ask to update this perhaps twice a year.

Talking about financials can be sensitive, and often parents are reluctant to discuss this with their children. Initially you can say, “We don’t need to know who advises you, what your assets are, etc., we just want to know that you have this information, and who to contact, in some document, in case one of us needs to step in to help you.”

This takes on more urgency if they are hospitalized or begin to have signs of early dementia.

Putting these plans in place is a process that takes place over time. In my own personal experience, once someone is diagnosed with a very serious health issue, they first think about updating their estate plans. You want to remind them that they also need to think about the plans that detail how they are honored and remembered when they die.

Talking to Your Parents About End of Life Planning

We've talked about how important it is to be a full partner with your partner, and we've offered some advice on when is the right time to discuss your end-of-life plans with your children.

Now for the flipside: How can adult children think about raising this topic with their parents? Here are some thoughts based on my own experience.

When is it Time to Discuss Your End of Life Plans with Your Children?

“Mom, I don’t want to talk about it!  You’re fine!”

This was my response to my mother, who had recently been diagnosed with a rare disease after a long period of being in and out of the hospital. She wanted to have me walk around the house with her, and show me what outfit she wanted to be buried in, who should get her beloved silver service, and many other things that I was not prepared to even hear. I was just 22, and at that age, no one wants to consider that they might lose a parent in the near future.

If you are in your 60s or older, you should be making plans about a great many decisions for when that time comes. And there is a time to discuss this with your adult children, although how much information you give them depends somewhat on their age and maturity.

For children in their 20s, I think it is just enough to let them know you are fine, but you have made plans for your burial arrangements when that time comes, and tell them where the file is.

By the time your children get into their 30s and 40s, they likely have a family of their own, but might wonder, depending on your health, if you have made plans. By this age, they are ready to discuss this subject in a factual way, and you can tell them more about those plans. For example, if you plan to be cremated, let them know why you made that choice. This is a good way to find out if they have concerns about your choices. You don’t have to change what your wishes are, but at least you know that more talking-it-over time might be a good thing.

When they reach 50 and beyond, they are usually very aware of the fragility of life, and have likely lost the parents of friends that were close, or perhaps colleagues from work. They may even be wondering what your plans are. By this time, if not before, it makes sense to have a longer conversation. It is a good idea if you can do this with all of your children present, so they all hear the same thing.

You should talk with them about your medical directives and health power of attorney, and who is named in that capacity. Explain to them what you want in terms of a service and a celebration of your life, that you have written out what you want, and have also made arrangements about burial and/or cremation. This should lead to questions, and will bring out concerns they may have.  

Depending on how ready you and they are for this, it is also a good idea to at least give them some indication of what happens financially when you die. When I say some, I mean giving a broad brush of those plans, such as “we plan to leave an equal amount to each of our children, and we have certain bequests we want made.” If the plans include treating heirs in an unequal manner, I believe it is better to get problems out on the table before you die, while there is time to reconcile everyone to what your plans are and why you made them. 

In the end, the best time is when you sense they are ready to begin to know more.

Planning for End of Life in Your Own Way

Planning for the end of life can be very liberating and uplifting, because it frees one from worry, and you know you are doing your family and friends the favor of taking care of you and remembering you the way you want.

This message comes across clearly in a newly released beautiful photo journal book by my smart and lovely friend Rita Foley: SHOW UP FOR LIFE EACH DAY…Living with Cancer

Here is an excerpt from her book on the benefits of planning:

“It is hard to think of one’s death, but planning for it is liberating.  I’ve heard stories of children arguing over who among them was going to give the eulogy or a particular reading.  The last thing one wants is to have his or her children falling away from one another after the parent is gone.  Planning can mitigate that.

Get your house in order.  By all means, make sure you have a will, a Healthcare Proxy, and any specific directives.

Planning is part of our everyday life in both work and in our personal affairs.  Many of us are used to doing contingency planning in work.  Do the same with end-of-life planning.   I put my objective, get-it-done, doer hat on when I planned for my end of life.  When using the logical side of my brain, my emotional side is put to rest.  I find it easy to talk about this stage to others when I can access that analytical side of me.

In the past year, I updated my will, completed my Healthcare Proxy, Power of Attorney, and end-or-life directives.  I have made my application to the only hospital in my area that will come and take my body for medical research immediately.  No waiting for the police to certify the death. My ashes will be returned to my family a year later.  I have specified where I would like my ashes to be spread—in special woods and areas where I will continue to be part of nature and of this earth.

No mourning when I go.  I want a party—a big one.  I have led a very full and wonderful life. So I have picked out where I want my memorial celebration to take place.  I have a list of desired speakers from each stage of my life.  I expect them to be funny and take the mickey out of me (a lovely old Irish phrase we used growing up, meaning make fun of).  I have requested that a particular jazz choir sing at the service, and I also want salsa and uplifting dance music to be played.  I love to dance.

With good planning, my load is lessened and I will be dancing out of the current life.

But not yet!”

Email rvfhome@aol.com if you are interested in ordering a copy of this wonderful book.

Have you started making your plans?

What is End of Life Planning?

When the subject of end of life planning comes up, most people immediately think estate planning: wills, trusts and other types of legal documents that detail how property (both financial and tangible) is distributed to heirs in the most tax efficient manner, best suited to each heir, based on their age or other criteria.

Others associate end of life planning with the medical decisions that are necessary to make on behalf of someone who is literally near the end of their life.  Does that person want extraordinary efforts to keep them alive? These directives are clarified in documents where one gives the power of attorney for health care to one or more persons. In that same document, they also make clear what they want in terms of prolonging life, relief from pain, and any other wishes they may have. Your estate planning attorney can also prepare your Advance Health Care Directive. For more information, go to http://www.nhdd.org/public-resources.

When I think of end of life planning, I am focused on how you want to be remembered, what kind of celebration you want, who you want to speak about the difference you made in so many other lives, your sense of humor, how you would never go out without your makeup on, how much you loved your grandchildren, your strength and courage, and so much more.

The third area of planning is rarely discussed, and there has not been much written about it. Likely because it is not a pleasant topic to bring up. Adult children find it hard to bring up this topic with their parents, for fear it sounds like they are not long on this earth. Aging parents don’t bring it up, because it is something they don’t want to think about. Yet it should be discussed, because you have made a difference in your life, and it should be celebrated and recognized at your death.

I learned this firsthand in my regular visits to see my Dad in his later years. As his named Executor, he would bring up the subject with me from time to time, telling me how he wanted the funds distributed, where to find his insurance policies, putting my name on his safe deposit box, etc.

After many visits, we really had exhausted the subject of dealing with the financial assets after his death. So gradually, he began to tell me what kind of service he wanted; that he wanted it on a Saturday morning, early, so no one would have to take time from work, and also not cut into their entire day. I knew his friends, but I asked him who he would want to speak at his service, and was surprised to hear the names of two men I did not know. One spoke about his incredible community service over 50+ years, and how valuable he had been in growing the assets of so many organizations, building endowments that would ensure their sustainability long after he was gone. The other individual spoke about what he had done for his church, both in building their endowment, but also his care of the elderly parishioners.

Once Dad told me who these men were, he told me about the organizations on whose boards he had served: the YMCA, The Visiting Nurses Association, and on and on, the kind of organizations that are essential in every community. On a subsequent visit, he sent me to the basement to look for something, and I found a trove of plaques that had been presented to Dad later in life for his lifetime service. There were eight of these, and I brought them upstairs and asked Dad if I could hang them in the hall. I could tell he was so pleased that he children would now know all he had done for others, and that just scratched the surface.

That is when it really hit me: everyone touches many lives in a positive way over their lifetime, where a kind word, or a thoughtful gesture brightens a day that has been difficult. More than that, we also improve the lives of people we work with, or mentor, our own children in raising them with important values. All of these encounters, whether just brief moments of interaction or long term associations, impact the lives of dozens, hundreds, even thousands of individuals, who in turn positively touch other lives. It is a powerful positive force.

And that deserves to be celebrated, to remind us all that, in the end, we recognize the truth of what Winston Churchill said: “We make a living by what we get, we make a life by what we give.”