Topics that rank high as difficult conversations: Wills, Death and Powers of Attorney. We feel uncomfortable thinking about our own deaths or those close to us dying. We know it’s important–but now isn’t a good time. The longer you wait, the harder and more urgent these decisions are.

child needing random acts of kindnessAre you playing peekaboo and hiding from difficult discussions about death and the things that need to be put in place?

Recently, I chaired a panel listening to presentations on death and dying. A particularly compelling presentation discussed the image of death portrayed by films and TV: heroic, tragic and swift, classic signs of approaching death, the impressive and meaningful last words.

Death is most often portrayed as the reverse of birth

Before I became a mediator, I worked with the elderly, those with life-limiting illnesses, the dying and their families. As a nurse and a midwife, I  have attended many deaths and births. There are many similarities. At both times, how the situation is handled is almost as important as the ultimate outcome. Get it wrong and not just one life, but several suffer. Both are natural processes and we may be unable to change the actual event. However, if we prepare and talk about the situation, the outcome can be much more constructive even in tragic situations. Death is portrayed as the worst possible outcome. . Believe me, death is not the worst thing that happens, and a good death is possible. The families who talked about the situation and put things in place early managed far better emotionally, socially and financially than those who didn’t. So having everything in place now saves ourselves and our loved ones.

Timing

With birth, we may not know exactly when it is going to happen, but there are clear signs of impending delivery, a fairly predictable time frame and the ability to prepare beforehand (usually). At the birth, there may only be 2 people in the room and then suddenly and audibly, there is another one (or more if multiple births). Babies don’t take part in the discussions about how they want to come into the world.

Death is not so predictable and each person and circumstance varies enormously. There may be no notice or years of dying. We may lose the ability to decide what we want or to implement our wishes.

Capacity

No one expects a baby to be able to express the care they want. Most babies thrive with love, food and safety. However, as adults, we are used to controlling or at least having an input into what happens in our lives. We rarely think about the many things that we have put in place to make our day to day live enjoyable. What would happen if you suddenly lost your ability to move or speak? Does anyone know what music you like to listen to, where the keys are kept or whether you like porridge or not? On a more serious note, who would you like to speak for you about financial and health matters if you can’t?

Provision

Generally, babies need less care as they grow older, and there is usually a time when they no longer need care.  Advances in medicine mean we might live to over 100, yet there will be increasing interventions with decreasing benefits. Instead of dying at 70 we may live 30 years requiring care. We need to accept that at some time we will die, and are likely to require assistance for some years. Planning gives us more choices–ignoring the situation until there is an emergency limits choice and control.

difficult conversations deathLiving life more fully by preparing for death.

With this in mind, St Cuthbert’s Hospice created a programme to help people get “everything in place.” Not only does it give the dying peace of mind, but it also reduces family conflict and uncertainty. It’s a better way to show you love your family than to buy life insurance! It covers care, advanced directives, powers of attorney, funerals and even options about  Facebook pages and passwords. If you haven’t the option to attend, this website  also provides some guidance about what you need to think about.

Before you write a will, a care plan or a lasting power of attorney, you need to have some difficult conversations with those close to you. The documents are only as useful as the amount of thought you put into them beforehand.

Having those difficult conversations: death and decline

The first step is to make up your mind to talk about death and decline–long before it seems likely

We are not immortal and health can be lost in an instant. When we are fit and active, it’s hard to imagine what it would be like not to be, but easier to research the options. Emotion is less likely to cloud your vision and the topic is easier to raise if not immediate.

Next, do a bit of what-if thinking

See it as a chance to brainstorm scenarios and solutions.

For example, is the house you (or parents) live in always going to meet your needs?  If not, could you adapt or is this the chance to move somewhere else?

What would happen if you couldn’t drive? What about stairs?

Doing some “what if” thinking doesn’t mean you will necessarily want to do it when you get to that stage, but it starts you thinking about the options and working out what is important to you.

Prioritise

Set some time aside to work out what is important to you in your life. Family? Friends? House? Pets? How can you make sure that this is shown now and in the future? Don’t wait until your death bed to wish you had spent less time at work. Life is fragile and things change. If you know your priorities, decisions are easier.

Think about

1. Who you would trust to do the following

    • speak up for you if you are ill and can’t speak up for yourself?
    • raise your children if you can’t
    • take care of finances

Choosing those people now means you keep control. If you are suddenly unable to make decisions, they may be made for you.

2. Who to talk to first

You may want to talk to a professional or a friend who can help you work out what you want to say before you talk to those closest to you. Is it important to talk to your children individually or together?

3. What you are going to say and how

The Dying Matters website has tips and resources. Don’t be too gloomy. Ask permission and make it safe for the other person. Not everyone is ready to talk about death, even if you are.

4. When and where you will do it

Starting difficult conversations about death is not easy. Here are some tips on how to get started

Do get in touch if you would like a conversation about difficult conversations, either about death or any other challenging topics.