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Never too early to discuss end-of-life issues with parents

By Anita Creamer

When Roberta Battle and her 10 siblings gathered in Washington, D.C., twice each year for their parents’ birthdays, her mother, Helen Harper White, always initiated a family business meeting. The agenda included her and her husband’s wills, their health care wishes, their financial situation – the entire spectrum of issues that experts call end-of-life planning.

When White died in 2009 at age 92, the family was prepared.

“With that background, I should be better prepared than I am myself,” said Battle, 67, a retired consultant who is president of Sacramento’s Older Women’s League. “I haven’t even done my own health care directive. I’ve just told my daughter things.”

For many families, it’s the most uncomfortable conversation they’ll ever have: How do their elders see their final years? What kind of life can they afford? How far do they want doctors to intervene in their last hours?

For millions of baby boomers and their parents, this conversation is the elephant in the room. And in today’s volatile political and financial landscape, experts say, frank discussions between the generations about money, health care and other end-of-life issues are all the more crucial.

Even when older people have carefully planned for their retirement years, today’s plummeting home values and rocky financial market can lead to concerns that they’ll outlive their resources – especially with the future of Social Security and Medicare in question.

Experts also note a more basic truth: You can’t honor your parents’ wishes if you don’t know them.

“If people won’t talk about it, they need to understand that at some point, somebody else will make those decisions for them,” said Barbara Gillogly, who chairs American River College’s gerontology department.

“Do you want the state to make those decisions? Do you want your adult children to make their best guess? Or do you want them to know?”

Only 15 percent of Americans – and 40 percent of senior community residents – have advance health care directives specifying how much medical treatment they want as their lives draw to a close, according to the National Center for Health Statistics. Half of Americans don’t have a will, according to a Harris Interactive poll.

Among the questions experts say the generations need to discuss: Do aging elders have health insurance, long-term care insurance or life insurance? Where is a list of the medications they take? What are their investments and income sources? And where are their important documents?

Do they have a living will and durable power of attorney (collectively referred to as an advance health care directive)? Who do they want making medical and financial decisions for them if they can’t? What funeral arrangements would they prefer?

Asking isn’t meddling, experts say; nor is it trying to take control. It’s just a smart way for one generation to care for another.

“My kids know where all of my passwords and PIN numbers are,” said Diane Balter, 64, a retired Sacramento attorney. “I have a little red folder in my house with all of my information, and I’ve given them copies of my living trust.”

She cared for her 98-year-old mother, at home and then in an assisted living center, before her mother died. In doing so, she learned that end-of-life decisions can be complicated and emotional even with planning, and she wants to spare her grown children as much burden as she can.

“We’ve talked about all this a little bit,” Balter said. “They really don’t want to hear it. I want to have the conversation with my kids, and they don’t want to have the conversation with me.”

That’s not surprising, says Gold River estate planning attorney Heather Chubb. She hands out questionnaires to her clients and their adult children on the older generation’s health care preferences – including how they define being a burden – and then they compare answers.

“You start the conversation, and you expect the door to get closed on you,” said Chubb. “We try to open the door a different way. That’s what we can do.

“We cannot force our families to do anything. Sometimes, we run up against a brick wall. Unfortunately, to surmount that wall, something drastic has to happen.”

And then – as Rosanne Bernardy, director of Sacramento’s Hart Senior Center, says – it can be too late. Delay and denial can rob families of their best chance to do what’s right by their elders, leaving adult children unprepared to face difficult financial and emotional realities.

Jane Rupp worked for a decade as a skilled nursing center’s nursing director, and she saw how heart-wrenching end-of-life decisions were for families whose parents hadn’t specified their wishes.

“If they’ve said what they want, then you’re not making the decisions,” said Rupp, who now provides staff training on advance directives for Eskaton communities. “You’re just honoring their wishes. It’s a significant difference.

“This is a gift you give your children. It’s a wonderful gift.”

Roberta Battle is ready to give her two grown children the gift of knowing what she wants. There are forms to fill out and decisions to be made, and her daughter is pushing her to make them.

“She’ll have all these things lined up for me to work on,” said Battle. “She takes after my mother.”