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Healthy Tips

The Conversation You Should Be Having

Making Decisions for the Future

You’ve written a will and discussed your healthcare decisions with your family — does that mean you’ve successfully planned for the future? One stage of life that is often overlooked, considered the fourth quarter, is your final 10 to 20 years. If you don’t plan for the end of life, you might find yourself in a crisis or even unable to participate in some of your healthcare decisions. A Northwestern Medicine geriatric specialist shares questions you can ask now for peace of mind in the future.

The Questions You Should Be Asking

“I’ve seen a lot of patients who need support but waited until the last minute. When they are sick, they are not able to be a part of that decision and are left out of the conversation,” says Lee A. Lindquist, MD, MPH, MBA, geriatrician at Northwestern Medicine. “It’s important to have these conversations early, and to see their plans.”

Some questions to consider:

  • What sort of life do you want to keep living?
  • Are you open to going to a senior community?
  • Is there a relative who could help assist?
  • What happens if your memory worsens?
  • If you are hospitalized, do you have a preference for the type of physical therapy you have?
  • Is there a plan in place if you fall?

“It all comes down to communicating with your loved ones,” Dr. Lindquist says. “As the years progress, you can implement the plans and communicate those goals to loved ones.” Together, you can make decisions that support your plan, whether it’s placing a ramp in your home or looking at senior living communities.

Having these conversations helps people prepare and in fact feel better that they’re not going to be a burden by setting expectations early.

“Whether you have a terminal disease or are healthy, everyone has needs as they age, and you’re going to need support,” says Dr. Lindquist. “We tell people to keep pushing. It’s going to be an ongoing discussion.” This will allow everyone to understand their goals and start making the appropriate plans to implement them over time. “End of life isn’t the time to be arguing or having these conversations. You want to have a solid grasp when you discuss your goals.”

Getting Additional Perspective

When Alzheimer’s disease or memory loss is involved, it’s especially important to involve loved ones early so they can understand the situation and you can have a voice in the conversation as the condition progresses. Consider bringing your loved one to appointments so they can see how the progression is evolving to better understand your deficits. “The toughest part is waiting until the writing is on the wall,” says Dr. Lindquist. Your loved one should not be blindsided when you’re in the emergency room or you have wandered off.

Fortunately, there are tools and resources like planyourlifespan.org to help steer the conversation. Having this discussion in a professional setting also allows a third party to provide framing around the situation as well as offer resources to enact your plan. “A lot of times we will see patients with their family members, and discuss what they’ll need in the future. There are fantastic resources available,” says Dr. Lindquist.

Home care programs are able to come to your home and evaluate it for safety. This assessment can include risk for falls or opportunities to enhance your safety at home.

Remember, it’s okay to ask for help. “This is part of the aging process and part of growing up,” says Dr. Lindquist. “You don’t want to get to a crisis. Now is the time to be having these discussions.”

Lee A. Lindquist, MD, MPH
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Associate Professor, Feinberg School of Medicine
  • Primary Specialty Geriatric Medicine
  • Secondary Specialty Internal Medicine
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