14 · SATURDAY, MAY 20, 2017 ADAPTING & ADJUSTING COMMUNICATION IS KEY Among the many needs that arise as family members age, are faced with a grave illness or expe-rience other life-changing situa-tions is the need to have difficult conversations. That could mean designating a health care power of attorney, discussing the type of care one would like at the end of his or her life and under what condi-tions to stop care. However, as important as these conversations are, many families are reluctant to have them. Ac-cording to a 2013 survey by the Massachusetts-based group The Conversation Project, which encourages people to have end-of- life talks at the kitchen table and not the intensive care unit, although 90 percent of people say it’s important to talk with loved ones about their wishes in the event of a life-threatening illness, only 27 percent have done so. And while 82 percent of people say it’s important to put their wishes in writing, only 23 percent have followed through. “It’s a hard conversation to have, but I’d call it one of the most crucial conversations you can have,” said Barb Gray, senior vice president of clinical services for Highmark. “It’s tough to face the fact that you’re going to lose a loved one or that you yourself are dying. But caretaking and being an ad-vocate for a loved one is one of the most important jobs you can do.” At theconversationproject.org, a number of starter kits are avail-able to help people initiate dis-cussions about end-of-life wishes. Not only do they have starter kits to help individuals speak with their families and loved ones about their own wishes, but they also have kits to talk about choosing and being a health care proxy, having the conversation with patients with dementia or Alzheimer’s Disease, talking to a doctor and having the conversa-tion with a seriously ill child. If a caregiver wants to have the conversation with a loved one but isn’t sure where to begin, there are a number of possible triggers that can make it easier, said Pa-tricia Hanson, managing director of IKOR of Western Pennsylvania, an advocacy and life manage-ment agency for seniors and the disabled. Those can include the death of a friend or loved one, an article, a television show, a sermon or something more directly related, such as financial planning or a change in health or medical diagnosis. One thing Hanson suggests is starting by asking your loved one to explain his or her experience of whatever the trigger might be. Often, it helps to discuss one’s own reactions first. So, for instance, if there was a television show about cancer, a family member could bring up how he or she felt watching the family members in the show deal with the situation and the feel-ings it brought up. “Taking it deep for yourself first GETTY IMAGES can give them permission to go emotionally deep in their experi-ence,” Hanson said. Hanson also suggested using the Five Wishes living will as a way to not only ascertain what a loved one will want moving for-ward but also create a legal docu-ment for their desires. The five wishes are “The Person I Want to Make Care Decisions for Me When I Can’t,” “The Kind of Medical Treatment I Want or Don’t Want,” “How Comfort-able I Want to Be,” “How I Want People to Treat Me,” and “What I Want My Loved Ones to Know.” For more information, visit agingwithdignity.org or speak with your physician. Other information that would be beneficial to have before a sit-uation becomes dire is what level of case management and support is available in one’s health plan, Gray said. Many can vary in terms of sup-port and services such as pallia-tive care, advocacy, etc. “Let’s face it; when this situ-ation hits, you’re going to be under an extreme amount of stress. If you’re trying to figure out where to turn, it’s even more stressful,” Gray said. “If you have a plan and you’re prepared, it gives you a great head start and doesn’t create more stress to where you’re trying to figure out a loved one’s final wishes or what your health plan can provide for you.” If a loved one is reluctant to have the conversation, it could be because he or she doesn’t feel comfortable taking about it with family members for fear of upset-ting them. For instance, Gray said, her father-in-law was often more comfortable discussing health matters with her, especially given her background in the field, than with her husband. If that’s the case, it might help to enlist the help of someone such as a professional or friend with a bit more distance than, for instance, a child might have. “It has to be a two-way con-versation, and sometimes hav-ing a third party makes it easier because sometimes people are so cognizant of a significant other’s feelings that it’s easier to talk with a third party,” Gray said. “There’s a freedom of not having to mince words because you don’t want to hurt someone’s feelings. Having a professional or paraprofessional or someone who’s been through this, some-one you trust, someone who can provide perspective is very important.” The difficult conversations are often most important At theconversationproject.org, a number of starter kits are available to help people initiate discussions about end-of-life wishes. BY KAREN PRICE
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