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Shortly before Thanksgiving, a family member experienced a traumatic stroke. 53 years old and previously healthy, his child is married to my daughter. They are both 26 years old. In one moment, all three lives were altered, and the ripple affect extends beyond me. Dad needs 24/7 care as he cannot walk, eat, drink or talk. Suddenly his son must make decisions that he is ill-prepared for, without the support of siblings. He has never been a parent and now he must parent his own father. He has had to search through his father’s belongings, gain access to his financial matters and make choices about long-term care for a man who has been fiercely independent his entire life.

Nothing can prepare you for this situation.

And yet, in a way, we can. I understand that one doesn’t want to think about catastrophic health events – the “what if?” situation that might render us incapable of taking care of ourselves. But, preparing can prevent much anguish for those loved ones who might end up taking care of us. Planning for a life-altering crisis is one of the most loving things that we can do for our family members and ourselves.

My son-in-law has moved his father to a long-term rehabilitation center near his home. Without private insurance, the choices were extremely limited. The facility he chose has a fancy website, with beautiful pictures and glowing statements about the services that they offer. Yet leaving his father alone that first night, and many nights thereafter, was gut-wrenching for my son-in-law. It occurred to me that it was just like leaving an infant in daycare. They cannot speak for themselves. They cannot tell you if something has gone wrong, if someone left them to cry alone, if they were fed when hungry, or attended to with love and care. The very young and very old cannot express their needs or report back if their needs aren’t met. So their loved ones are left to guess, hope, and worry.

The difference however, is that we are supposed to worry about our children. It feels natural to do so. We have nine months to prepare ourselves psychologically and emotionally for this transition to a new role. For many of us, we can seek out our own parents for support and understanding when we become new parents.

As is often the case, my daughter’s father-in-law can communicate a great deal with his eyes. There are moments when his eyes convey delight, mainly when his beloved dog comes to visit. But these moments are very infrequent. Most of the time his eyes tell us that he is disgusted, humiliated, depressed and angry.

My son-in-law is doing a wonderful job seeking out and accepting help. I feel very grateful for the opportunity to help him and his father, and to feel closer to them. But the guilt and grief that he feels is palpable. These feelings are multiplied because there was very little preparation for this event. The financial and medical decision-making is based on what he thinks his father would want. But he needs to have conversations with him. How does he really feel about the feeding tube? Does he want to participate in therapies? Does he want his depression treated? They cannot converse about any of these important topics.

Life is fragile and it is never too early to have these conversations – for ourselves or for our loved ones.  I challenge you to prepare – initiate a conversation about what you want – or what your family members want – and put it in writing.

Yes, it will be uncomfortable. Yes, it will be sad. But often times the most loving choices aren’t the most comfortable ones.

The Mayo Clinic has a good description of advanced directives and living wills:

Dr. Chris Lawrence
Dr. Chris Lawrence
Dr. Chris Lawrence is a licensed clinical psychologist and professor of psychology at the University of Missouri-Columbia and Stephens College. She is co-owner of Lawrence, Oliver and Associates, a private practice clinic in Columbia, Missouri. To learn more go to
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