1. Making Plans for the End of Life Sandy Bailey, Ph.D., CFLE Marsha Goetting, Ph.D., CFP, CFCS MSU Extension Specialist

2. What is “Old?” 18-29 year olds – 60 years Middle-aged people – 70 years Individuals 65 and older – 74 years

3. Markers of old age differ between young and old

4. More people today die of chronic illness than in previous generations when an acute illness may have caused death.

5. Bringing up the topic of death I read that most people today die of chronic illness in later life and was wondering what I would want to happen to me in that situation.

6. Have you heard about living wills and advanced directives? I just learned about them and thought I would fill one out.

7. I know you are in great health and I hope you live to be 100 but as your daughter what do you want me to do if you became seriously ill?

8. I heard that planning ahead for the end of life is more important today than ever.

9. My friend who lost her mother told me that no one ever told her how to help her parents die – it was hard for her to make decisions. What would you want me to do in that case?

10. I need to talk to you. What would you like to have happen if you are unable to live alone and take care of yourself?

11. You have done such a great job organizing your finances and writing a will, but what about your care should you become seriously ill?

12. Components of Introducing the Topic Using “I” statements Framing that you respect the individual Framing how hard it would be for his/her loved ones

13. Components of Introducing the Topic Articulating the need to make choices now before he/she can not make a choice Aligning with the person Importance of planning

14. AIKIDO (From Powerful Tools for Caregivers, 2010, Class #4) Align Agree Redirect Resolve

15. DESC (From Powerful Tools for Caregivers 2010, Class #4) Describe Express Specify Consequence

16. Dealing with resistance in the discussion I guess you don’t want to talk about this right now. I would like to talk about it in the near future.

17. I would be very upset if I had to make these decisions for you and did not know what your wishes were.

18. Perhaps more information would help us. I will gather some and leave it for you to read. Then we can discuss it later.

19. Dealing with other family members We all have our own fears and comfort levels in discussing death Different birth order of siblings may result in differing view Different age cohorts may have differing views

20. Where do I start when my loved one needs more help than I can give? Assisted living facilities Rehabilitation facilities In-home care Adult Day Care Nursing homes Hospice

21. Common Emotions for the Care Recipient at the End of Life Anger Fear Guilt/regret Contentment or discomfort about how they lived Heightened spirituality Anxiety/depression

22. The Roller Coaster Ride

23. Rewinding

24. In Summary Enter into the conversation being sensitive and respectful Be aware of your own feelings related to end of life issues

25. In Summary Acknowledge other family members feelings related to end of life issues Keep a gentle but persistent effort until the decisions are made

26. New Montana Document to assist with end of life decision making POLST