The Conversation.

April 7, 2024

The Conversation.

May 29, 2023

When you are young and healthy, you believe you will live forever. You do not worry about losing any of your capabilities. You are willing to delay gratification—to invest years in gaining skills and resources for a brighter future. You plug into bigger streams of knowledge and information. You widen your networks of friends and connections.

But…when you see the future ahead of you as finite and uncertain, your focus shifts to the here and now, to everyday pleasures and the people closest to you. This, according to Stanford psychologist Laura Carstensen, has to do with perspective.

Walter Green, now age 85, philanthropist and founder of the “Say it Now Movement” discussed his perspective of life in a recent podcast with Dr. Peter Attia and stressed the importance of expressing sentiments to loved ones well before the end of life. “If you can give the gift of a special relationship to people you care about, there is no more beautiful gift,” he says, adding, “Don’t wait until it is too late to have these difficult conversations. Knowing the answers to these questions and others will help you both to find emotional independence and gratitude.”   

If you or a loved one has a significant health issue, or if you are one of the many people thrust into the role of caregiving, or if you simply want to plan so that you can get back to enjoying midlife, I encourage you to have (and document) a conversation that covers some of the important items below.

To get started, choose the right time and place by finding a quiet and comfortable setting where you can have privacy and uninterrupted time to talk. Prepare yourself. Reflect on your own feelings and concerns about the topic. Be empathetic, patient, and ready to listen. Recognize that this conversation may evoke strong emotions for you and others. 

Begin by framing the conversation. Gently introduce the topic of care by explaining why it's important to discuss. You can say you want to make sure you are prepared for any situation and that your loved one’s wishes are respected.

Encourage the person to share thoughts, feelings, and concerns by using open-ended questions such as: "Have you thought about what kind of care you would like in the future?"  Or “Is there anything specific you want to make sure is in place as you become more incapacitated?

Honor the person's autonomy and preferences and let them lead the conversation at their own pace.

Offer information about care options, such as hospitals, advanced care nursing facilities, independent living, hospice, palliative care, advance directives, and legal matters like wills and power of attorney. Be prepared to answer questions or guide them to appropriate resources. Ask about after death preferences such as burial vs. cremation, green burial or other.

Quality of life questions should be addressed, keeping in mind that a physician’s role is to ensure health and survival. “But,” according to Dr. Atul Gawande, author of Being Mortal, “it is larger than that. It is to enable well-being, and well-being is about the reasons one wishes to be alive.” Sometimes that entails making the difficult decision to let one go.  

If to be human is to be limited, or in limbo between life and death, as my father-in-law is currently, then the role of caring professionals and institutions ought to be to aid people in their struggle with those limits.   “Whatever we, as physicians, can offer, our interventions and the risks and sacrifices they entail, are justified only if they serve the larger aims of a person’s life. One of the most meaningful experiences is helping others deal with what medicine cannot do as well as what it can,” Gawande acknowledges.

As a caregiver, we know it is very difficult to take time away from your role, yet being good to yourself is one of the most important things you can do to extend your effectiveness. Personally, I have found the programs offered by MEA in Baja, and soon Santa Fe, to be exceptionally restorative. After a loved one’s passing, if that is the outcome you experience, you may want to explore connecting with a new purpose by enrolling in a special workshop or simply take part in a wellness retreat. This will enable you to meet others and develop a lasting community of kind, sensitive and like hearted people.

“Sometimes we just need time away—to be present with ourselves so we can reset and rejuvenate.”  MEA allows you to do that.

-Barbara

Barbara Kreisman holds a PhD in Leadership and Organizational Dynamics,  and is a current Fellow in the University of Chicago Leadership and Society Initiative.  Barb, a four-time MEA alum, is an emerita professor at the University of Denver where she teaches in the Knoebel Institute for Healthy Aging (KIHA).

Go deeper with a workshop, in person or online.

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