A woman reviews and documents end-of-life wishes with her mother.

Start a New Holiday Tradition – An Annual Review of End-of-Life Wishes

L. Allison Givens, MSW/LCSW, Bethesda Hospice Care | November 19, 2019

As we prepare for our holidays… the turkeys of Thanksgiving, the gifts of Christmas, and the lights of Hanukkah, take a moment to think of your family and what you want them to know about your end-of-life wishes.

From the time I was 12 years old, I knew exactly what my parents wanted at the end of their lives. I knew they wanted to be organ donors, they wanted to be cremated, and they wanted their ashes spread in a particular place loved by our family. While I don’t remember exactly how the conversation started, I know that it was around the time of the Karen Ann Quinlan case—the young woman that was in a persistent vegetative state that made international news. At one point, the review of their end-of-life desires became an annual discussion.

The Benefits of Planning Ahead

Flash forward to when I was 26 years old, and my father had his first heart attack. He was 58 with no prior health problems of significance. He was in Texas and I was in Missouri, and my brother lived even farther away. About 8 hours later, he had his second and final heart attack. My brother and I did not suffer, because we couldn’t say good-bye in person. We were comforted that he had made his wishes known to us. We immediately consented for organ donation, and he was cremated just as he had requested.

Two days later, we held a Memorial Service for friends and family. We were stunned at the people that came forward and chastised us for going forward with cremation and organ donation, stating that they really knew what he wanted. I’m not saying that his choices were right for everyone, but it was his choice—clearly articulated by him and discussed with us. Because of our discussions, we were spared the agony of trying to figure out what he would have wanted. We were at peace, because we know we responded as he wished we would. We later received letters of thanks from organizations that were able to benefit from his organs. Months later, after the birth of my second child, we gathered and spread his ashes in the desired location.

I began working in Hospice Care when I was in my late 20’s, and I continue to work in the field today. I’ve had my own children determine their end-of-life choices when they became licensed drivers. You just never know when those decisions will be needed. I am constantly surprised in my work when I meet people that have never discussed their end-of-life wishes with their loved ones. It is so much easier to talk about than you imagine.

Quick Tips for Discussing End-of-Life Wishes

I think the winter holidays are a perfect occasion to talk about end-of-life wishes. The extended family is together, and I’ve found, more often than not, that family members appreciate knowing what your wishes are. Stating what your end-of-life wishes are, knowing your spouse’s, and telling your family about them will help open the discussion. In the end, having this conversation will bring peace of mind to your family.

This is how I would get the conversation going: “I’ve been thinking about what you want to happen when you die. Have you ever thought of that?” Follow up with some additional questions about their end-of-life wishes:

Other important questions to ask:

While having this conversation is crucial, it is also important to write down those wishes so that they are not forgotten and family is spared crisis decision making. There are simple forms designating a Health Care Agent and Durable Power of Attorney for Health Care and Finances available through the Missouri Bar Association website. These forms allow you to select what, if any, life-prolonging methods you are willing to try—ventilator, tube feeding, etc. They also allow you to choose a decision maker if you can no longer make your own. I am my Mom’s decision maker—not because I am her favorite (although I’m sure I am!) but because she knows I will be able to carry out her wishes. Pick someone who you know will stand up for what you want.

Final Thoughts

Mark Twain is credited with a saying that if you eat a frog first thing in the morning, the rest of the day will be better. Eat the frog. Have that conversation. The first time will be challenging, but after that, a simple yearly review will suffice. Discussion topics could include any changes in your end-of-life wishes or confirming the location of your lock box key.

So consider starting a new holiday tradition this year. Let your family know what you want. It’s a gift they will appreciate.

Find more retirement and end-of-life planning tips like these on our blog.

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