Difficult Conversations:How to talk to your loved ones

about your health

Dana Nolan MS, LMHC, NCCLicensed Mental Health Counselor

Talking about…

Conversations to have when you are well:• Living Will• Last Will and Testament• Organ Donation/anatomical donation

Conversations when you are ill:• Diagnosis of Life Threatening Illness• Prognosis• Do Not Resuscitate (DNR)

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Why can conversations about our health be difficult

Denial of our mortality Hard to imagine ourselves or

our loved ones sick Societal pressure to only think

about positive outcomes

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Why are these conversations necessary?

Elephant in the room YOUR wishes will be carried out Your family members KNOW your

thoughts/feelings and don’t have to guess Your family has the knowledge to plan

their lives and get support if needed No one has ever died from hearing the

news that a loved one has a potentially life threatening illness

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What are Advance Directives? Conversations about your Advance Directives are

best had when you are well. If Terry Schiavo had completed an advance directive

in writing, she would have had her wishes known and carried out.

Living Will - a legal statement about what kind of medical care you want or don’t want if you become unable to make your own decisions. • Difference between a living will and DNR• You do not need an attorney to complete a living

will

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Advance Directives (con’t)

Health Care Surrogate legal document naming another

person as your representative to make medical decisions for you if you are not able to make them yourself. • You do not need an attorney

to help you with this process

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What if you don’t have a Health Care Surrogate?

Next of kin:• Legal Guardian, Spouse, Adult Children of patient,

Parents of patient, oldest sibling/majority of siblings, close relatives involved in care, close friends involved in care.

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Difference between Power of Attorney and Healthcare Surrogate Designation

Durable power of attorney allows for much broader powers than a Healthcare Surrogate Designation

No limitations on the decision making.

Strongly recommended that an attorney assist with this process

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What a Health Care Surrogate can provide consent for:

Decide on the patient’s level of care when the patient cannot

Consult with caregivers and give informed consent for treatment

Have access to medical records and authorize release of information as needed

Apply for benefits & avoid cost of an attorney

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What a Health Care Surrogate cannot provide consent for:

Abortion, Sterilization, Electroconvulsive therapy, Psychosurgery, Experimental treatments or therapies, Voluntary admission to a mental health facility

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Advance Directives (con’t)

Anatomical Donation Legal document that indicates your wish to donate,

at death, all or part of your body.

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Talking about your illness

Adjusting to news of your own serious diagnosis Telling others can be challenging

• Emotions of co-workers, parents, friends, children, siblings, neighbors

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Talking about your illness (con’t)

What to tell and when?• Cost/benefit analysis

Children/grandchildren• To tell or not to tell

Boss/co-workers

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Prognosis

Asking your physician “How long do I have?” is a tough question• Our physicians don’t give their opinion on

prognosis unless you ask

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Prognosis (con’t)

Disclosing a limited prognosis to loved ones

Deciding to decline further curative treatment….Is this giving up?

End of Life discussions…Is talking about what kind of funeral/burial you want being pessimistic?

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Do Not Resuscitate Order

What is this and who can enact one? Discussion with your treating physician

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Conclusion

Gone are the days when Cancer was whispered about.

We know that having difficult conversations reduce anxiety about the unknown for patients and family

Lots of resources to help with having those conversations

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Contact Information

1-800-615-2270

(800) 615-2270