How to Talk to Your Family

Help Your Family Understand Your Choices

An Advance Healthcare Directive is not a substitute for a discussion with your family.

People come from many different ethnic and religious backgrounds. Certainly, each generation within a family has a historical perspective that shapes its behaviors and values. Older generations will more likely have survived the death of relatives and friends. Some may have served in wartime. Younger generations may be the result of intercultural marriages and may be more comfortable with the dominant cultural themes of life in America such as democracy, individual personality, autonomy, and freedom. So even within one family, the individuals may not share the same attitudes and opinions regarding end-of-life wishes.

Many family members are surprised to learn that a loved one has written an Advance Healthcare Directive (AHD). Many parents now write an AHD to spare their children the distress of making difficult decisions in a time that might already be too painful. It is crucial to discuss your AHD with your family if you want to ensure that your wishes will be carried out.

For the purposes of this discussion, the term family is used to mean that individual or group of individuals that are your loving support system whether or not they are actually related to you.

How to Begin

Share with your family the reasons that you have filled out an AHD. Let your family understand the values and experiences that have shaped your decision-making. You could share the concerns you have about maintaining the ability to continue activities that make life meaningful to you.

Describe when you would want to limit aggressive treatment and how aggressively would you want pain controlled. Would you want to be kept alive by artificial feeding through a tube? What thoughts do you have on how others have died? What is the legacy that you want to leave to your family that survives you, including how you want to be remembered?

These family talks may be awkward, but they are crucial to avoid the unnecessary strife, arguments, confusion and unwanted medical interventions that may otherwise occur at the end of life.

Setting Aside Time to Talk

A good place to talk is at home during a family get-together. The home setting is a relaxed and safe environment for many.

Another time to talk may be during a doctor's office visit. You can request a family conference that you and your family attend. In this setting, the doctor can be available to act as a moderator, to answer questions regarding medical issues, and to document the discussion of your preferences in your medical chart.

In your family talk, be sure to include the person that you have chosen to be your durable power of attorney for healthcare decisions. If necessary, this is the person that will make informed decisions for you. Notify all your family members who this person will be and give your surrogate decision-maker a copy of your AHD at that time.