Starting Difficult Conversations - Advance Care Planning

Difficult conversations -  the phrase says it all.   There are some topics in life that are difficult to approach.  End of life planning is one of them.  Learn how to start the sometimes difficult conversation about advance care planning with the people closest to you in this week's Changing Lives Podcast episode.

About Hospice Quinte
Hospice Quinte provides individuals, their families, and caregivers with compassionate end of life care, by attending to their physical, psychosocial, and practical needs, and offering empathetic care to those who are grieving through visiting hospice services and support groups.  All Hospice Quinte programs and services are provided by compassionate, well-trained volunteers and staff at no charge to the individual or their family.  

Hospice Quinte serves a population of over 102,000 in Quinte West, Belleville, Deseronto, Tyendinaga Township and the Tyendinaga Mohawk Territory. To find out more visit HospiceQuinte.ca.

Transcript

Difficult conversations -  the phrase says it all.   There are some topics in life that are difficult to approach.

·        For instance :   Ending or changing relationships – is a topic that’s difficult and a conversation that is always hard to start.

·        Life insurance salespeople will readily admit – that their job is made more difficult because people generally do not like conversations about the possibility of dying.

·        Having to discuss long term care plans with parents – is a very difficult and uncomfortable conversation to begin.

Even though approaching these conversations can be daunting, they are very necessary conversations. There are some ways in which those conversations can be started and made easier – Here are some statistics and pointers that you might find helpful in having and starting difficult conversations.

Advance Care Planning in Canada was an initiative formed in 2008 – with the express purpose of helping Canadians start difficult conversations.  In 2019, they commissioned a poll to gauge people’s attitudes about planning for their future health and personal care.  Compared to a previous study done 6 years earlier in 2013, there had been a noticeable increase in people having those discussions.

What they found was that 44% of people in 2013 thought it important to talk about advance care planning.   By 2019, that number had more than doubled to 93%.

This is good news for those of us who need to start difficult conversations!  WHY?? Because advance care planning has not only become a common buzz-word in our society, BUT is showing up on people’s radar – to the point that it was commonplace for 93% of those polled to have those conversations.

In spite of that, the 2019 poll did bring to light a couple of statistics that brought concern.  In spite of the fact that 8 in ten Canadians have given some thought to end of life planning, only 2 of those 8 actually HAD a plan. Furthermore – even though 79% of Canadians have talked to someone about their future plans, only 36% of those conversations was with family.

So then – how DO we start the conversation ?  And what can we do to make those conversations easier and effective?

Here are 4 tips that we think will help:

First – before you even start the conversation,  do your homework.   Collect as much information and seek out possible solutions so that the conversation can begin with information.  Any conversation is better when it starts at a place of being informed.

Second – Stick your toe in the water!   And no, we don’t mean take your parents for a swim!  

Before starting the conversation,  take the time to get a sense of whether they are OPEN to having the discussion.   This can be done by introducing related topics, mentioning something you read, or even talking about statistics.  

Then gauge their response – if they are open or defensive or even evasive --- these will give you clues as to how open they are to having the discussion.

Thirdly – Choose the right person to have the conversation.   It is worth taking the time to consider if this conversation would be best had by a third party.  Often a neutral third party like a doctor, a family friend or even a cleric would be better suited for tricky topics like “When is it time to give up your licence” or “should we talk about long term care?”  Often, third party people can lay the groundwork, explaining what they noticed was wrong, and making suggestions, and are able to do so without risking a strained relationship.

And fourth  - Now that you’ve done your homework, and tested the water – and considered who the best messenger is --- Take the plunge.  Start with a compliment --- and look for an opening…. And follow their cues.

Rephrase what you hear your parents saying, as a way to let them know you are hearing them and that you are supporting them.

And then steer the conversation gently to the difficult topic.  Difficult Topics that may come up could include:

-                     Should they consider giving up driving

-                     Mental Health – and dementia – is their memory failing

-                     When is it no longer save to live alone? 

-                     Should they consider Long Term Care?  When do you step in ?

-                     Have they chosen a Power of Attorney?

-                     Do they have a will and where is it stored?

-                     What are their funeral wishes?

Though these conversations are DIFFICULT, they are very important.

Working towards open dialogue is something worth doing.  For questions on advance care planning, and difficult conversations, contact us at Hospice Quinte – we can help.