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The Difficult Discussion We All Must Have—

but spend too much time avoiding


It was my birthday last month. And, despite all the scheduling acrobatics to get three adult sons, wives, and grandsons from across the country in one spot to blow out my birthday cake candles, it happened.


I’m sure it was easier to send humans to the moon and back. But on this one occasion, everyone was here.


At some point in our lives, most of us have played some sort of sport. The coach typically calls out, “Okay everybody, listen up,” or something like that. It’s time to pay attention. So now for the serious perspective on this occasion.


Most of us are aware of the terms living will, advance directives, healthcare surrogate, and estate planning, but few of us really pay attention. The proof: Less than half of Americans have seriously addressed these documents. In one report only 9 percent of us had valid living wills on file. And the results can be a nightmare of end-of-life decision-making, financial Armageddon, and a legal mess for families to untangle when you head for the great hereafter.


With no orderly designation or wishes for your death scenario or what happens after, the decisions made at the bedside and the transfer of assets can divide families for generations.


“Okay everybody, listen up.”


Following our delightful family birthday dinner and the blowing out of the candles, we all retreated to comfortable spots in the living room where I tactfully demystified and unpacked how crucial these emotional and financial decisions are.


The urgency of this family meeting was brought on by my near-fatal car accident two months prior. You don’t need a scary event and a ride in an ambulance to realize the importance of these family discussions. Life alone is dangerous. And interestingly, my oldest son is a paramedic in Chicago, so you can imagine what he sees at work every single day.


Like I said, “Listen up.”


I explained to my beloved family why there really is a moral imperative to do this right. There is no second chance, no do-overs. The ideal setting to discuss who makes medical decisions if you can’t and how the trust is structured and your wishes for your funeral is best handled during the light of day rather than under the glare of the beeping monitors in a busy emergency room. Or hastily trying to find a funeral home online or searching Google for a local attorney to handle probate.


And guess what?


For the first time in history, everyone put away their smartphones. There was no idle chatter about politics. Everyone showed up with their A games.


We all realized we need to take ownership of these decisions, to respect the decisions made about resuscitation, and we don’t need an armada of attorneys and accountants to do this the right way if we plan ahead.


We touched on designating a surrogate who would speak for us if we cannot speak for ourselves about healthcare decisions (such as being in a coma or on a respirator or if we even want to be on a respirator), and we addressed each of us documenting the aggressiveness of care we would want if we were in a situation for which there was no reasonable probability of cure (I am DNR).


We talked about the difference between hospice medicine and palliative care. The hospice program is a Medicare benefit focusing on patients during the last six months of life. Palliative medicine is a branch of internal medicine addressing quality of life issues anytime in the trajectory of a patient’s illness.


The bottom line for our family and I hope for yours is this:


  • These kinds of opportunities when families are together rarely happen. Take advantage of the reunion picnic or birthday or anniversary or even wedding. The meaningfulness of the event will not be overshadowed by what some may think is a gruesome discussion and want to avoid.

  • These discussions are crucial and need to be done or the fallout can be a nightmare.

  • Tell key family members their roles as surrogates or executors. Have a list of where important documents are kept. Who the family lawyer is. Who the accountant is. Who the financial advisor is. Keys to safe deposit boxes. Life insurance documents. Computer passwords. Wills. Trusts. Investments.

  • Simply open up a browser and search for individuals who did not have a will—athletes, celebrities, captains of industry, people of prominence—and read about the squabbling and legal mess they left with no happy endings.

  • A clear take-home message: If you don’t take care of your business and complete documents such as living wills and trusts, someone will do it for you. And they may not have your best interest at heart.

  • Don’t wait for a frightening event or health scare. Get your documents completed and signed. Talk with the family attorney or find one. Download documents from reliable legal websites that pertain to your state.

  • For more guidance on how to make these vital healthcare decisions, I explain in more depth in my newly revised book (just updated with audiobook too): Farewell: Vital End-of-Life Questions with Candid Answers.



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