Initiating a conversation about death is difficult. Few people want to dwell on their own mortality, and the younger you are, the more likely you are to put off considering end-of-life arrangements. To many people, death is something that happens to others, but, unfortunately, it’s an experience we will all encounter. That’s why end-of-life planning is important for emotional as well as financial reasons. Fading Memories presents the following guide that can help you as you begin making some end-of-life decisions.
Planning is difficult to discuss
Believe it or not, even doctors have a hard time initiating conversations about death. In a poll of physicians cited on Today’s Geriatric Medicine, only 12 percent reported having end-of-life discussions with their heart failure patients. Those who experience serious heart conditions are, of course, at a much higher risk of death, so this relatively low percentage is telling about the lack of connection between physicians and patients when it comes to discussions about death. And in many instances, when the topic comes up, it may be too late as the patient is already in the midst of a terminal illness.
It then falls upon family members to initiate end-of-life discussions with loved ones. Although few want to dwell on such topics, it is possible to approach end-of-life discussions with pragmatism and even optimism, notes Sixty and Me. The key may be to clear the air and strike a balance between enjoying life and planning for the future.
Ease the conversation to make it less overwhelming
End-of-life discussions are avoided because of their perceived pessimism, but also because people can quickly become overwhelmed by such important decisions. In order to facilitate free discussion, you can approach the topic as a physician would. Frame the conversation in terms of goals. If your loved one is terminally ill, these goals can be incorporated into a care plan with their physician and palliative care nurses and other supports.
If your loved one wants to live to see a particular birthday, or wedding of a grandchild, for example, these goals can be addressed with a doctor. Certain treatments, such as chemotherapy in a cancer patient, may prolong life at the expense of comfort. Communication is essential to not only learning about options but also weighing options against others. It’s also important to view end-of-life discussions as not a conversation but a series of ongoing talks.
Specific topics to discuss
When communicating about end-of-life planning, the following are some additional topics that might be important to your loved one:
- Nursing home care preferences (use online tools to help you find the top-rated facilities in and around Brooklyn)
- Aging-in-place options
- Reasonable life expectancies
- Advanced directives, such as living wills and organ donation
- Estate planning
Sources of financing
The need for end-of-life care raises financial concerns as well. From assisted living to nursing home care, a terminally ill patient is going to have a host of additional expenses. Medicare now covers end-of-life discussions with a physician, but there are many expenses that are not covered by government programs or insurance, at least not until assets are exhausted.
One asset that may provide fuel for end-of-life care is a life insurance policy. Policyholders can sell these policies to investors in a practice called a life settlement, which provides cash today in exchange for forgoing a future life insurance benefit. These transactions are complex, so it would make sense to involve a financial planner. The amount of cash available is determined by many factors, including age, health, cash surrender value and amount of monthly premiums. Sold or settled policies usually see a cash return from single percentages to up to 30 percent of the benefit value.
No one enjoys talking about death, but the conversation can be retooled into a discussion of quality of life. Although doctors have a role, family members are key players in steering the conversation for optimal care, emotional health and financial stability.
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