AAMC: The Important Conversation We’re Not Having
Can we talk for a minute? When you hear this question, you wonder, what is this going to be about? You might fear the worst.
But one conversation about a very important, albeit uncomfortable, subject can make all the difference.
I’m talking about sharing your wishes for end-of-life care.
I’ve been a registered nurse for 27 years. I’ve coached other families on the importance of having end-of-life discussions as a trained facilitator for The Conversation Project, a national campaign dedicated to helping people talk about their wishes for end-of-life care.
An experience in my own family served as my wakeup call for why talking matters. My aunt went to the hospital for what we thought was a quick visit for a chronic condition. We didn’t know she wouldn’t be returning home. She suffered a massive stroke and was unable to move her right arm or leg or even speak.
Without a medical power of attorney or living will, her husband automatically became decision maker. Facing the greatest grief of his life, he was now burdened with some very difficult choices. He turned to me for help and, together, we blindly did the best we could. We made decisions based on what we thought my aunt would have wanted.
Too often people die in a way they wouldn’t choose, leaving loved ones feeling guilty and uncertain. According to The Conversation Project National Survey, 90 percent of people say talking with their loved ones about end-of-life care is important. Yet only 27 percent of people have actually done so.
Many of us find ourselves having the conversation about end-of-life wishes over our loved ones’ hospital beds. Let’s not save this important conversation until there is a medical crisis.
How do I start?
This topic often triggers fear in loved ones that something is wrong.
Break the ice by immediately deflecting from the worst. You might start with, “Even though I’m OK right now, I want to be prepared.” Or, “I need to think about the future. Will you help me?”
When’s a good time?
Timing can be an essential element to having the conversation. Initiate the conversation when your family is together, perhaps during a holiday or family event. Also use life’s milestones, such as a birthday or graduation, to spark the conversation.
What to talk about?
Here are just a few things you should consider discussing:
Who would you like to make decisions on your behalf?
What affairs (finances, property, relationships, etc.) do you need to get in order, or talk to your family about?
Where do you want, or not want, to receive care?
What kinds of treatment (resuscitation, breathing support, feeding tube, etc.) do you want or not want? Your first conversation should be the first of many.
So remember, you don’t have to cover everyone or everything at once. Find more information about The Conversation Project and get free tools to help you start talking at www.askAAMC.org/Conversation.
Ann Marie Holland, MSN, CNOR, FNE-A, RN-BC, is a clinical education specialist at Anne Arundel Medical Center.