Gerontologists and other health professionals who work with those facing death say end-of-life conversations generally are valuable to both...

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WASHINGTON — Gerontologists and other health professionals who work with those facing death say end-of-life conversations generally are valuable to both the patient and family. They also concede such conversations are difficult and, sadly, rare.

Here are some tips they offer to patients and their relatives on conducting such a talk:

• It’s up to you whether your talk concerns just practical affairs or deeper emotions. The conversation can range from whether a dying parent wants a feeding tube or ventilator to the music he wants played at his funeral, or if he wants a funeral at all, says Capital Hospice Chief Executive Malene J. Davis, a former hospice nurse.

• There are several ways to broach the topic. To a receptive parent, an adult child might open with, “Mom, do you want to talk about this? You know what the doctors say?” suggests Arlington, Va., psychotherapist Robin McMahon. The parent could say, “I am dying, I would like to tell you what my life has meant to me.”

• Another option is to tell a story about someone else to start the conversation, Davis suggests. “You tell them you have a friend who is dying and ‘I need to know about what you want, how you feel.’ If they close you out, don’t give up, go back at another time.”

• A holiday family dinner offers an opportunity to raise the subject, Davis says. An adult child might begin by expressing thanks for the gift he is about to share: explicit instructions regarding his own death. “Instead of starting with Dad or Mom, say, ‘If I got hit by a truck tomorrow, this is what I would want. … And don’t you dare dress me in pajamas in my coffin.’ “

It’s not always the parent who resists such a conversation. If kids are in denial, McMahon says, “a wise parent fills out an advance directive so the adult child has something.”

If parents are in denial, the children can give them a living will, durable power of attorney and other documents and say, “Here it is, read it some time. It’s here for when you need it.” Parents reluctant to discuss this with their children, or to cede control of their assets, might want a lawyer or accountant to take over their finances or give a child limited control.

An adult child might preface money discussions by talking about herself, explaining who in her family knows about her assets before asking her parents to reveal theirs. That question might be phrased, “If I needed to, where would I find your papers?” Davis says.