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How to Have Difficult Family Conversations During the Holidays

Nov 12, 2020 4:00:10 PM

As the holidays approach, families will gather, either in person or virtually. Between bites of pumpkin pie or during the football game halftime, consider using the time together to discuss some difficult subjects, such as family health history and end-of-life planning for aging parents or relatives.

How To Discuss End-of-Life Plans | HSWO


Ask your loved one what is most important to them during the last phase of life. Do they have a wish list of things to accomplish, or any personal relationships they wish to mend? Do they have any fears to share with a pastor or spiritual adviser?

Why tackle the difficult subjects during a time of celebration? Having these challenging conversations while everyone is together can help to avoid misunderstandings and ensure everyone has the opportunity to share their personal wishes and concerns with everyone present.

According to a 2018 national survey by The Conversation Project, “92% of people say that talking with their loved one about end-of-life care is important,” but only 32% actually do.

Are you ready to have the conversation? Some ideas to help you get started:

Use technology to send a group email, chat or text. If you have a large family or people you only see a few times per year, consider sending a group email or text message before you get together. Let everyone know you’d like to initiate the conversation and ask them to gather some thoughts before you meet. If family members are reluctant to engage in the conversation, don’t force it. These conversations go best when everyone is on board. 

Prepare by doing a self-check. — It can be helpful to write down your own fears or concerns before you reach out to your family. Think about your own end-of-life planning. What is important to you? Are you worried about financial assets, or are there specific traditions you want to pass down? Thinking about your own wishes can help you focus on what you want to discuss with your family. If this is the first time you’ve talked about plans, remember that it may take many conversations over time. 

Try a little tenderness. — If your parent or loved one seems unwilling to discuss their wishes, gently try to get them to open up about why they are hesitant. The goal is not to make them anxious or upset, but rather to find the root of what is bothering them. For example, are they worried about upsetting the family, or are they afraid to open up about such a personal subject? According to dyingmatters.org, “one of the easiest ways of opening up the subject is to ask your relative or friend who they would like you to contact if they became very seriously ill.” 

Don’t be too hard on yourself. — It’s normal to feel hesitant about these conversations. The last thing anyone wants is for their parents to feel the conversation is insensitive or self-serving. Preparation is key when broaching the subject. In her article Having “The Talk”: How to Discuss End-of-Life Issues with Parents, author Carol Bradley Bursack suggests beginning with medical concerns rather than financial concerns.

Family health history can be a good place to start

Starting with a discussion of family health history and medical concerns can ease the family into the conversation. Discuss your own preferences with others. For example, do you want a full medical history to consider genetic testing for cancer or other diseases, or would you rather not have all of the details? Consider everyone’s perspective and let your parent or loved one express their own wishes in the scenario. 

Discuss what is most important to know about your loved one’s end-of-life wishes

  • Once you’ve discussed family health history, you can talk about what level of medical care and interventions you and your loved ones want or don’t want. 
  • For example, would your loved one want a feeding tube if they were no longer able to eat on their own? Do they have religious or spiritual beliefs that might impact the level of life saving measures they want?
  • What about the location of care? 
  • Do they want to remain in their own home or move into a retirement community or healthcare facility? 
  • When would it be ok shift from a focus on care that cures to a focus on care that comforts?

The Conversation Project offers a free Conversation Starter Kit designed to help families organize thoughts to have conversations with loved ones. 

Hospice of Southwest Ohio is here to help with the difficult conversations. We offer an advanced care planning program, called Voice your Choice, to help families understand options and learn how to communicate those wishes to loved ones.

To learn more about the programs and services available to you by your hometown hospice provider, visit hswo.org.

Hospice of Southwest Ohio
Written by Hospice of Southwest Ohio

Hospice of Southwest Ohio provides care, comfort and compassion for those facing a life-limiting illness. We have a dedicated team of nurses, caregivers and volunteers whose main goal is to keep your loved ones at peace – in a place surrounded by care and compassion. We serve four counties around Cincinnati, Ohio, with the highest reputation for treating patients with dignity and respect.

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