Making Plans for the End of Life

Sandy Bailey, Ph.D., CFLEMarsha Goetting, Ph.D., CFP, CFCS

MSU Extension Specialist

What is “Old?”• 18-29 year olds –60 years

• Middle-aged people–70 years

• Individuals 65 and older–74 years

Markers of old age differ between young and old

More people today die of chronic illness than in previous generations when an acute illness may have caused death.

Bringing up the topic of death

• I read that most people today die of chronic illness in later life and was wondering what I would want to happen to me in that situation.

• Have you heard about living wills and advanced directives? I just learned about them and thought I would fill one out.

• I know you are in great health and I hope you live to be 100 but as your daughter what do you want me to do if you became seriously ill?

• I heard that planning ahead for the end of life is more important today than ever.

• My friend who lost her mother told me that no one ever told her how to help her parents die – it was hard for her to make decisions. What would you want me to do in that case?

• I need to talk to you. What would you like to have happen if you are unable to live alone and take care of yourself?

• You have done such a great job organizing your finances and writing a will, but what about your care should you become seriously ill?

Components of Introducing the Topic

• Using “I” statements• Framing that you respect

the individual• Framing how hard it would be

for his/her loved ones

Components of Introducing the Topic

• Articulating the need to make choices now before he/she can not make a choice• Aligning with the person• Importance of planning

AIKIDO(From Powerful Tools for Caregivers, 2010, Class #4)

•Align•Agree•Redirect•Resolve

DESC(From Powerful Tools for Caregivers 2010, Class #4)

•Describe• Express• Specify•Consequence

Dealing with resistance in the discussion

• I guess you don’t want to talk about this right now. I would like to talk about it in the near future.

• I would be very upset if I had to make these decisions for you and did not know what your wishes were.

•Perhaps more information would help us. I will gather some and leave it for you to read. Then we can discuss it later.

Dealing with other family members• We all have our own fears and

comfort levels in discussing death• Different birth order of siblings may

result in differing view• Different age cohorts may have

differing views

Where do I start when my loved one needs more help than I can give?

• Assisted living facilities• Rehabilitation facilities• In-home care• Adult Day Care• Nursing homes• Hospice

Common Emotions for the Care Recipient at the End of Life• Anger• Fear• Guilt/regret• Contentment or discomfort about how

they lived• Heightened spirituality• Anxiety/depression

The Roller Coaster Ride

Rewinding

In Summary• Enter into the

conversation being sensitive and respectful• Be aware of your own

feelings related to end of life issues

In Summary• Acknowledge other family

members feelings related to end of life issues• Keep a gentle but persistent

effort until the decisions are made

New Montana Document to assist with end of life decision making

POLST