Initiating “the Talk”

adrouin April 5th, 2011, 11:50 AM
Amy Dixon, BSN, RN
Author Profile

I blogged about the Joan and Melissa Rivers Campaign on Aging last December. It got me thinking about how I could initiate the discussion with my own mother about aging and advanced directives for health care. She becomes Medicare-eligible this month. My fellow nurse colleague, Paula Wilson, explains advanced directives in her blog.

I feel it’s crucial to have advanced directives, including a living will and a durable power of attorney or health care proxy in place, should my mother require hospitalization. It will take me some time to travel to her in such an occurrence. Knowing that a health care proxy is in place would ease my mind that her wishes are being followed if she cannot speak for herself.

It eases my mother’s mind, too.

On a recent visit to Ohio, near the one-year anniversary of my father’s death, I cautiously broached the topic with her.

We were at a lovely diner full of lush, green plants. The sun was shining through the window. We had just finished our chicken dumpling soups. It was our last day together and I had just helped her with her taxes earlier in the day—for the first time, she would be filing as a single person.

I figured if we were on a roll organizing her financial matters I may as well keep along those lines of open communication.

“Mom,” I said, “I’m sure you’ve heard about a Living Will and Durable Power of Attorney.” (In Ohio, we use the term Durable Power of Attorney as opposed to Health Care Proxy, which is what we say in New York. They mean the same thing.)

“Do you mean for my finances?” she asked, “because I’ve been thinking about that.”

“A Durable Power of Attorney is a person who can make medical decisions for you in the event that you cannot do so for yourself,” I replied. “ That person is someone who can follow your wishes. Someone who can speak for you.”

“Yeah, I’ve been thinking about that, too. I have papers about that from when I had my knee surgery,” she said.

“Mom, I just think it may be a good idea to think about those papers again, if you feel comfortable.”

My mom expressed her preference to  initiate the process, as it would make her feel relieved knowing that me or my brother have the authority to carry out her wishes.

As we moved on to our main lunch dish we continued to talk about the advanced directives. She even began to talk about her considerations for pre-funeral planning, as well as how she would like to organize finances for the future. The initial topic she proposed above. She guided the rest of the discussion on her own.

I sometimes wonder if it’s actually the adult child who has reluctance to discuss these matters as opposed to the senior parent. It’s not easy hearing your healthy adult parent mention her own funeral wishes, but it also has a sense of decompression. The “talk” relieves all this perceived built-up pressure imagined in one’s mind. It wasn’t as difficult as I thought it would be. In fact, it has given us a clearer path to more honest, direct communication regarding important issues in our lives.

My mom now feels taken care of by her family. Her children know what she wants. My brother and I feel at ease because we understand her wishes in advance, as opposed to the worry of fumbling through difficult decisions in a time of crisis.

You can initiate advanced directives, living wills and health care proxy forms on your own in my many states via internet-available forms, but please ensure they are appropriate sites. Talk to a physician or health care professional if you are not sure. You may even want to ask your physician if he or she carries living will documents at the office. Be aware that each state’s documents are different and that you may need to have a witnesses or a notary public present at the signing of the documents.

Here are some more links regarding the topic of advanced directives:

AARP’s Advanced Directives Article

The US Living Will Registry

As my colleague, Paula Wilson, mentioned at the close of her blog. Advanced directives are not only important for the elderly, but for each and every one of us.


  • Thanks for covering this important subject. A colleague of mine, an elderlaw attorney, very wisely pointed out that every adult over the age of 18 needs to have these documents in place.
    And, as you pointed out, although the documents are important, it is the discussions you had with your mom that brought your family to a place of understanding and trust about her wishes and future.
    Thank you!
    Dale Carter, Transition Aging Parents

  • YES! “The Talk” is certainly one of those ripple effect topics. Adult children start the discussion in mind for their older parents, and then think about how it’s relevant in all of our lives. You’re right! Advanced Directives are no longer a “senior” issue. Thanks for you comment.

  • I’d say the talk you had went as well as it could have. I think you’re right – sometimes we build up anxiety about a topic in our minds – and then when it comes to fruition, we are relieved that it turned out to be so much easier than what we anticipated. Good for you for initiating what had to be an uncomfortable discussion, especially so close to the death of your father.

Show All Comments (5)

Submit a Comment