LAST WISHES PART 1: The Conversation

Talk about difficult conversations—sitting your adult children down to hear how you want to be treated at the end of your life is about the worst. That’s why I met with Susan Plummer, PhD, who heads an organization that helps families with the Conversation.

Susan Plummer, PhD

Susan Plummer, PhD

If there’s one thing your grown children don’t want to hear about, it’s a world without you. “Oh, Mother, you’re so morbid!” they’ll say when a parent tries to broach the subject. They’ll clamp their hands over their ears, chant a nursery rhyme, or even run from the room--anything rather than confront the issue of their parent’s mortality. Susan Plummer, PhD, Executive Director of the Alliance for Living and Dying Well, urges you to persevere.

“To get the Conversation started, you can thank your children for giving you the gift of peace of mind by allowing you to communicate how you want to be treated at the end of your life. There is a real comfort for you in their knowing your choices, thereby maximizing the chance that those choices will be respected.

“You are also giving them a real gift. You are modeling adult responsibility in the form of preparation.  Moreover, you are revealing yourself as a nuanced individual, not just a cardboard cutout of a parent. And it shows you see a role for them in your well-being. Your relationship can become more intimate and compassionate as result.

“It’s more effective if the whole family is there at the same time for the Conversation. Then everyone hears the same thing at the same time. If your child is married, it is better if his/her spouse is in the room; the more ears on the topic, the better. Someone could take notes and distribute it to all members of the family afterward. For those families whose members who are scattered, there’s always Skype, Google Hangouts, etc.  One family I know of even had the Conversation at Thanksgiving, when the matriarch put her wishes in the form of an advance care directive on each plate and said, ‘We’re not going to eat until we go over mine and you fill out yours!’

“If, despite all your efforts, you are still meeting resistance, you might try a third-party facilitator. Some retirement homes, churches and community centers have parent/child advance planning workshops, which helps to depersonalize the subject. However you do it, realize that the Conversation is not just for old people and it shouldn’t take place just once. The more you have it, the more routine and matter-of-fact it becomes. It’s like lab work, just another part of high-quality health care.”

In our next Thursday post, Susan Plummer will discuss the Advance Care Directive, the document on which the Conversation is based. Until then, we’d love to hear about your own experience with end-of-life talks with your grown offspring.

Susan Plummer, PhD, is Director of the Alliance for Living and Dying Well. She is the author of Deep Change: Befriending the Unknown and serves clients in her private psychotherapy practice. To contact Dr. Plummer, email her at

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