Conversations with adult children about their aging parents eventually include the dilemma of declining health. Embedded in this emotional topic is the volatile issue of “advanced directives.” Everyone knows that you need one, but having just one version turns out not to be enough.
The directive is a contextual document where the marching orders of the past may no longer apply or need clarification with changing health. In good health, where disease and death seem to be distant rumors, the advanced directive can be brisk and definitive: Don’t let me suffer; pull the plug. Fair enough.
But once our aging parents slip into chronic illness, the “prior” directives may be mismatched for the new burden. The reality of illness that won’t go away transforms the brisk and definitive to more complex algorithms of “if this, then that” along with caveats that offer compassionate wiggle room. At this point, it is not unusual for older couples to diverge in what they do and don’t want from medicine and the family’s good intentions.
The beginning of the end of life creates the third contextual mandate to revisit the directives. In this sacred space, all previous bets may be off the table. No one knows what they really want until they stand face to face with their final act. What we do know is that the final marching orders should be our best efforts to find the right blend of compassion, comfort, and courage, a middle ground between suffering and release, between just enough and not too much…