Making
Plans for the
End of Life
Sandy Bailey, Ph.D., CFLE
Marsha 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