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Illustration by April Dela Noche Milne

“So,” my wise friend Barbara intones, “have you had the Talk with your kids yet?”

“Not yet,” I admit sheepishly. “They’re so busy with their own lives, and right now that’s the last thing they want to think about.”

Barbara, who spent her career as a psychologist, prods me. Gently. “You’ve already put the plan on the backburner for a few months and now it’s how you want it. This is a good time to broach the subject.”

My kids are 36 and almost 40, so the Talk I was avoiding wasn’t about the birds and the bees, they’ve figured that one out. The topic I was in a tizzy about, though, was going to be equally awkward to discuss and the audience even less receptive: I needed to talk to my children about making health care decisions for me in the future.

Barbara had spent considerable time guiding a friend and me through the process of mulling over and then committing to paper our end-of-life wishes – details about the type of health and personal care I’ll want at a time when I may not be able to speak for myself. And perhaps to spell out specific end-of-life choices. I had not yet done the hard part: making sure that my kids – and my husband of 40-plus years – knew the details of my advance care plan and understood my motivations.

Preparing the advance-care plan led to a lot of discussion in our group. Surprisingly, it was even fun! Yet challenging, too, because I had to think about issues like DNRs and heroic measures. Life support or not? Tube-feeding? All of it is difficult to imagine, in my current healthy, happy state. But I had to admit: it’s one thing to talk about in theory and quite another if things change substantially and the time came to put the plan into action.

The touchiest subject was who would speak for me if I couldn’t speak for myself. I originally named both my kids as health care power of attorney, or substitute decision maker, if my husband wasn’t able to do the honours. But what if one of my children was unavailable and the need to make decisions in a timely manner was critical? Part of the Talk I needed to have was to let my kids know that my daughter would be my substitute decision maker. She would speak for me when I couldn’t speak for myself. This didn’t mean her brother wouldn’t be consulted, it merely eliminated steps.

And yes, despite the topic and its implications, I had some laughs working things out. Considering the details of my own funeral felt like any other event planning. Where would it be held? At my beautiful cottage? Improbable because it’s in the middle of nowhere. But hey, a girl can dream! Who would attend? Would there be food? Would there be music? Yes and yes to the latter, because I am currently imagining the equivalent of an Irish wake.

The women I volunteer with at Dying with Dignity Canada are a clever lot. They devised wily ways to have the Talk with their kids. Barbara’s strategy was to invite them out to brunch. She figured there would be minimal eye rolling, the kids would stay seated while they listened and then they would walk out with satisfied stomachs and a copy of the plan.

Roz, one of the most organized people in our group, created a binder for her kids with a table of contents, dividers and coloured tabs. The binder contains all the important documents her children will need to help with end-of-life decision-making for her and her husband, including Power of Attorney for Care and Power of Attorney for Finances as well as their wills, banking and investment information, and even burial plot documents.

She created one binder for each son and there is a “master” binder she maintains at home. Roz intends to update amended or new information. Her younger son didn’t want to talk about his parents’ ultimate demise, but she had the Talk with him nonetheless. He was greatly relieved when he learned he didn’t have to make decisions and that his role was to be mom or dad’s “mouthpiece” if they couldn’t speak for themselves. He graciously accepted that responsibility and he was pleased to take possession of the binder, as was his older brother. Roz is fairly certain neither son has cracked it open yet.

How far did I get with my family? I shared my plan with my husband so he could write his own version. We agreed it would be smart to plan ahead so our kids won’t have to sort things out in a time of crisis.

I’m pretty sure my kids didn’t realize I had to screw up my courage to have the Talk. They understood my rationale about asking my daughter to be my substitute decision maker. But we’re not done. My husband still has to finish his paperwork. He hasn’t prioritized it as I have. When that’s done, we’ll have to have a longer chat so they understand our wishes well in advance.

I may have to book a table at a busy restaurant for that occasion.

Rita Scagnetti lives in Thornhill, Ont.

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