Are you prepared to have this incredibly difficult conversation?

An article in yesterday’s paper stopped us in our tracks yesterday and had the whole Starts at 60 team arguing.
Let's Talk

An article in yesterday’s paper stopped us in our tracks yesterday and had the whole Starts at 60 team arguing. It was a beautifully written piece by a young woman studying to become a geriatrician and she opened with this line:

“The day you meet me in the emergency department with your sick parent is likely to be one of the worst days of your life.”

Dr Ashleigh Witt eloquently describes the situation in which you might meet her, giving the scenario of your elderly mother being admitted to the hospital with pneumonia, which is on top of her existing health issues. She will ask you about your mum’s health, what’s happened to land her in hospital. And then she’ll ask how aggressively you want the doctors to treat her.

At this point, any person would probably want to say “do everything you can”. But what if that’s not what you mother wants? What if she doesn’t want endless tests, or CPR when her heart fails. If she’s unconscious at this point, it’s up to you to know what she wants.

Which depends on you having had one of the hardest conversations you can imagine – the one in which you ask your parent, or in another set of circumstances tell your children, what you want in the final years and then moments of life.

Dr Witt says, “As doctors, we have the ability to keep a person alive indefinitely. If our lungs fail, we can put a tube down your throat and have a machine breathe for you. If your kidneys fail, we can attach you to a machine that filters the toxins from your blood. We can even mimic the function of the heart. We can fill your veins with tubes and lines and attach you to life support.

“If the patient in front of me is 21, we usually do all of those things. If the patient in front of me is 101, I probably would do none of those things and focus on their comfort.

“Every other patient falls somewhere along that spectrum, and tonight, I need you to tell me about your mum so we can work out where she fits.”

Here at Starts at 60, some of us wanted to stick our fingers in our ears and sing “la la la” when faced with the prospect of talking to our parents about the end of their life and what they might want. Others felt moved to find the courage to have the conversation.

In closing her moving piece, Dr Witt urges everyone, “Please have this talk this week, regardless of whether your parents are 60 or 100. Your future self will thank you for it.”

Have you had this conversation with your children or parents? Is it something you are afraid of? Share your stories to help others. 


  1. My dad signed a Health Care Directive which was filed on his medical record at the hospital he attended for his heart condition. My parents told us that they had both discussed the issue with the treating doctor. In the end, when they both passed away it was a blessed release for them. It would have been selfish and cruel to wish then to stay longer in the state of health they were suffering. After dad passed away, mum followed in about 6 months. She was so ill and had given up the battle.

  2. This is such an important conversation to have. Thank you for publishing the article.

  3. We’ve discussed it with our sons and drawn up the documents. I watched my mother die from bone cancer and my father lose his ability to walk and fend for himself, becoming totally dependent on others as his mobility deteriorated. It made my husband and Me think about our own death. We don’t want any heroics, if there is no cure and treatment is not going to prolong life then let us go. I hope laws to allow assisted dying are in place soon as a choice too.

  4. Death is inevitable for us all, to be unprepared for death I think is worse than being unprepared for life. We are only on this earth for a short time but we will be dead forever

  5. Had this conversation years ago. There are a lot of shades of grey. How I want to be treated comes down to prognosis and whether I have dementia. If I have dementia let them give me pain relief I’m allergic to and not much else. If there is a good prognosis, then we will go with treatment.

  6. All adults should make sure their parents have an Advanced Health Directive! It make it so much easier. As Julie said, it’s all written down,, my Dad has one, do Yours!

  7. This article has prompted me to ‘revisit’ the Advance Health Directive I started to complete some time ago. I’m terrified that the last weeks/months/years of my life will be spent in an undignified, vague (and of course, painful) representation of ‘who I am’! I’ve always been a strong advocate of euthanasia but, given the procrastination of government, doubt that this issue will be settled in my life time!

    My other greatest fear is that, even though I’ve made it clear to ‘all and sundry’ the extent of my wishes, some bloody ‘do gooder’ will stick their finger in the pie and stop them from being acted upon.

    • Once you have signed the directive it can’t be altered by anyone. Get a solicitor to do it for you as they will also attest that you were mentally capable od signing it at the time. It’s a legal document.

    • Ruth Hourigan They are not the simplest of documents are they? Legal document – so is a Will but we constantly hear of others ‘contesting’ them. We will live and ‘die’ in hope!

  8. I have an Advanced health directive as did my husband. I have found that while Power of Attorney is well known there is less awareness of this vitally important document which needs to be completed in ADVANCE!

  9. We all gonna die eventually it’s just a matter of who’s gonna go first nothing will last forever even those rocks will deteriorate by constant rain and flooding

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