Technique 1: Refer to a friend's or a family member's experience."Talk about when Aunt Susan was very sick and the doctor spoke with cousin Nancy about possible treatment options," suggests Ellen Surburg, R.N., the director of Bloomington Hospital Home Health & Hospice, in Bloomington, Indiana. "Explain why that was difficult for you to watch―how it made you realize you need to know what's right for your mom and what kinds of things she would want, so you don't end up in the same situation." Whatever scenario you use to introduce the topic, it's important to cast the conversation as something you need for your own peace of mind, says Elinor Ginzler, a program director for AARP, in Washington, D.C.
Technique 2: Take a cue from current events.A news story does not have to be as dramatic as the Terri Schiavo case to be a conversation starter. A local medical-ethics controversy or a report about a terrible accident can serve as an opening to say, "You know, any of us could be in a situation like that without warning. We should really talk about what we would want if that were our family."
Technique 3: Use story lines from books, movies, and TV.Popular culture is full of narratives about aging and illness, although it can be a lot less grim on ER than in real life. Renting an old favorite film, like On Golden Pond, could create an opening. Dad might start talking after watching cancer-ridden gunslinger John Wayne in The Shootist. A TV commercial aimed at older viewers, even if it's cheesy and you're both laughing at it, could set the stage. Or mention a book or an article you've read, like this one.
Technique 4: Come up with your own plan and share it.Using yourself as an example can be a good tactic. Do your own advanced-care planning while you're young and healthy, and ask them to do the same.
Technique 5: Bring up the issue at a holiday get-together.You wouldn't want to serve a living will alongside the pumpkin pie, but starting out with a "While we're all here…" can be a good way to raise the issue of your parents' future. Your family dynamics will determine whether you should begin the conversation alone with Mom and Dad or bring in your brothers and sisters. But it is important to eventually get everyone on the same page―Mom and Dad's page, that is. That can be challenging if your family has conflicts or different religious beliefs. If you anticipate or encounter difficulties, bring in a third party. An aunt or an uncle who is one step removed can help, as can the clergy or social workers.
Technique 6: Be receptive if Mom or Dad raises the topic.Sometimes it's not the parent who avoids the conversation. If your mother reaches out, "don't say, 'Oh, you're still so young,'" says Marty Richards, an affiliate assistant professor of social work at the University of Washington in Seattle. Use the opportunity to segue easily into uncomfortable territory. Even if you have trouble talking about your mortality, don't deprive them of the chance to talk about theirs.