On the occasion of the National Family Caregiver month this November, this article is dedicated to sharing on a topic that we think does not get the attention that it deserves.
Not nearly enough guides on helping ailing loved ones focus on preparing us for making decisions that will be hard for us to know we’re doing so in line with what their wishes.
While many are held back from having these tough conversations about end-of-life, they don’t realize that they are more likely to ease emotional distress rather than add on to it.
What is a living will ?
Living wills are an idea that I picked up while reading Dr. Atul Gawande’s book “Being Mortal” 1.
Dr. Gawande has drawn inspiration from his unique background of being a son caring for a parent that was slowly become sicker. He also draws from personal experience treating and interviewing hundreds of patients.
Why is a living will important?
Dr. Gawande managed, through his work, to create a systematic approach that gives patients a feeling of relief and a sense of control. This is important because the focus should be on what the patient wants - not just which treatments will extend life.
Don’t get me wrong, this doesn’t mean you give up on getting them the best treatments, but instead, you look at what priorities are most important to them.
It’s not just about asking what is suitable for a patient from a medical standpoint, but what does a good life look like to them?
The OECD weights objective wellbeing, defined as the number of years that a person aged 65, is expected to live in a state of good health as the most critical factor for wellbeing in aging.2
How to have this tough conversation - 5 questions to guide you
We should be able to provide our loved ones with a life that they want, not one that suits our conscience. Here are the five questions recommended by Dr. Gawande :
1. What is your understanding of where you are and of your illness?
2. What are your fears or worries about the future?
3. What are your goals and priorities?
4. What outcomes are unacceptable to you? What are you willing to sacrifice and not?
5. What would a good day look like?
Having a hard time kicking off the conversation
In the book, Dr. Gawande tells the story of one of his patients who says he will be OK as long as he can eat chocolate ice cream and watch football. He later used this as an example of his conversation with his terminally ill father. In mentioning it to his dad, his father responds: “Well, that wouldn’t be enough for me. I’ll tell you what I want…”
So the example opened the door to having a conversation for them. Perhaps it can serve that purpose for you as well.
Mon Tonton - community for wellness as we age
While caring for your aging parent is a labor of love, it is still labor. Adult children can be thrust into the caregiver role when they least expect it. It only takes an aging parent’s illness, a slip in the bathroom, or an accident.
At Mon Tonton, we want to provide you with the knowledge and resources to age well at home. Whatever that means for you or your loved ones.
Atul Gawande, Being Mortal: Medicine and what matters in the end ↩
Columbia University, Measuring the Adaptation of Countries to Societal Aging ↩