Conversation Scripts: Getting Past the Resistance WHY TALK ABOUT MEDICAL PREFERENCES IN ADVANCE?

Conversation Scripts: Getting Past the Resistance
WHY TALK ABOUT MEDICAL PREFERENCES IN ADVANCE?

Tool #6

Communication is the single most important step in health care planning. Talk about your wishes with the people who may be called upon to speak or decide for you. Why is this important?

1. No matter what your advance directive says, others will not fully understand your wishes. The more thoroughly you communicate, the easier it will be for everyone to respect your wishes.
   
2. It will help you think about what you want. Others will ask you questions or tell you things that will make you think about your wishes in another way.
   
3. It will help your loved ones make difficult decisions with less pain, doubt, and anxiety.
   
4. It may save money. Sometimes families continue medical treatments long past the point where they are helpful, simply because they are unsure what their loved one
   would have wanted. This is emotionally and financially costly ... and unnecessary.
   
5. It may even bring your family closer together.
   

STARTING THE DISCUSSION
There’s no “right” way to start. Nor is there a “right” time. Nor does the discussion necessarily have to be somber and mournful. Here are some suggestions for getting started:

• Start with a story of someone else’s experience:
  “Do you remember what happened to so-and-so and what his family went through? I don’t want you to have to go through that with me. That’s why I want to talk about this now, while we can.”
  “Neither Richard Nixon nor Jackie Kennedy was placed on life support. I wonder if they had living wills and made what they wanted clear in advance.”
  
• Blame it on your attorney:
  “Mr. Darrow, my lawyer, says that before I complete some legal documents, I need to talk
  over with you some plans about end-of-life medical care.”
  
• Use the worksheets provided in this packet to guide the discussion. A variety of other workbooks are also available. (See Tool #10 – Resources: Advance Planning.)
  

ABA Commission on Law and Aging Tool 6 / Page 1

• Use a letter, tape, or video recording as a starting point. At first, it may be easier for people to hear what you have to say if you are not there. Afterwards they may be more ready to sit down and talk with you.
  “Mom, I don’t see what good it does to talk about such things. It’s all in God’s hands anyway.”
  “Dad, I already know you don’t want any heroic measures if things are really bad. There’s nothing more we need to discuss about it. We’ll do the right thing if the situation arises.”
  “I just can’t talk about this. It’s too painful, and talking about it just makes it more likely that it will happen.”
  
• Be firm and straightforward.
  “I know this makes you feel uncomfortable, but I need you to listen, to hear what I have to
  say. It’s very important to me.”
  “Yes, death is in God’s hands, but how we live until that moment is in our hands, and that’s what I need to talk to you about.”
  “If it is too overwhelming for you right now, I understand. But let’s make an appointment for a specific time to sit down together to discuss this. All right?”
  
• Point out the possible consequences of not talking now.
  “If we don’t talk about this now, we could both end up in a situation that is even more
  uncomfortable. I’d really like to avoid that if I could.”
  
• Ask someone to be your spokesperson.
  If you are able to connect well with one family member or friend, ask this person to initiate and lead the discussion with other family members or your doctor. This may make your job of explaining, clarifying, and answering questions easier.
  

RESISTANCE TO THE DISCUSSION IS COMMON, FOR EXAMPLE...

IN RESPONSE...

ABA Commission on Law and Aging Tool 6 / Page 2 
source http://www.americanbar.org/content/dam/aba/migrated/aging/toolkit/tool6.authcheckdam.pdf