Daily, I encounter families faced with tough decisions about their parents and life-threatening situations.  For some, their parents can fully participate in these decisions; for others, the children are left on their own to decide. Either way, these decisions are never easy for children to make. Two recent examples:
  • A dad with dementia has lived in a secure memory care unit for over a year.  Health problems have landed him in the hospital, and with his quality of life limited his family faces tough decisions.
Given that his best case scenario is not good, do they agree to do surgery?  Provide blood transfusions?  Even give him antibiotics?
  • A mom who is cognitively intact is DONE with living.  In the last few months, she has lost her long-term spouse and had a stroke.  She has chosen to refuse any food or medicine, knowing the outcome of her decision.
Does the family intervene or defer to their mom’s decision? What actions do the families take?  In both cases, the families know what their parents want. Yet when it comes time to actually make the decision, to honor the will of their parents, the children agonize. We never want to lose our parents.  But how do you want your loved ones to live the final stage of their lives? The truth is, neither of these families has easy days ahead of them. The children struggle to stand by and watch mom make the decision to refuse treatment. The children also struggle to make these choices on the behalf of someone who can’t decide for themselves, even if they know their wishes. There is underlying doubt and worrisome “what ifs” no matter what decisions are made. And guilt.  Lots of guilt wondering if more intervention might have made a difference.  Guilt between wanting to keep them with us and honoring their wishes.

But here is the key:  Both of these families KNOW what their loved ones want.

They have all had discussions about end-of-life wishes and made plans.  And even though what they are going through this week is tough, imagine how much worse it might have been with out that knowledge.  We never know when end-of-life decisions, tough decisions, will need to be made.  So it is important that we talk with our families about what we want in such a moment, no matter our age. Talk about how you want to live the end-of-life stage.
  • What does quality of life mean to you?
  • What conditions or circumstances would mean that you would refuse medical intervention?
Talking about these questions empower our loved ones to make good, tough choices when that moment comes.  These discussions also empower us to get what we want when the end of our lives approaches. So have the discussions today.  Make your wishes known.  Put them in writing, if you can.  And then keep revisiting the conversation as time passes and life changes.  It is one of the best gifts you can give yourself and your loved ones.