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A Different Kind of Mother’s Day Gift

May 14, 2012 By toughconversations Leave a Comment

What to get my wife for Mother’s Day? Beyond the requisite flowers, dinner out, or Whitman’s Sampler, what to give?

At various times my wife has asked me: “What am I supposed to do in an emergency?” “What if you get very sick, or worse….?” “Whom do I call?” “Where do I look for your insurance papers, information on your pension, etc?” When I showed her where I keep our vital documents, she replied: “How can anyone find anything in there?”

So, I got a loose-leaf notebook with plenty of tabs and set to work. The first page lists critical phone numbers: Whom to call regarding my pension, our retirement accounts, insurance companies, long-term care, etc.

Next, a table of contents. Then the tabs:
Tab A – An article titled: “Checklist for Surviving Spouses” (an article from an investment magazine). And a list of our bank accounts. retirement plans with their numbers, etc.
Tab B – Face sheets from our insurance policies and long-term care plans.
Tab C – Copy of my Will.
Tab D – A spreadsheet listing the Passwords and Pin numbers for websites such as banks, insurance companies, phone and cable companies, and so on. Also under that tab are pages where I scanned the fronts and backs of my credit cards, drivers license, Medicare ID, and other information I carry in my wallet. Another page contains the front and back of our passports.
Tab E – Copies of our Advance Medical Directives and Powers of Attorney for Health Care and Financial matters.
Tab F – Funeral Arrangements

What I thought would require days took only a few hours. I’m sure there are items I didn’t think of. As soon as I recall them, I’ll pop them in the notebook.

My wife reviewed it, thanked me for putting everything in one binder, and now stores it where she can easily access it.

Done!

Sig Cohen

P.S. If you want expert help assembling your vital information check: www.documentroadmap.com. Among its services, it scans, organizes, and transfers copies of your vital documents to a USB memory stick. Clever, no?

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Leave ‘Em Laughing

May 7, 2012 By toughconversations Leave a Comment

When a conversation gets tense or goes silent, a little levity can do wonders. President Ronald Reagan, “the Great Communicator” was a master at this. One of his finest performances occurred in the operating room of George Washington University Hospital on March 30, 1981. He’d been shot, and doctors were desperately trying to stop his massive internal bleeding. He’d already had four transfusions and had lost half his own blood

A team of surgeons was preparing to anesthetize him so they could open his chest, repair the damage, and retrieve an attempted assassin’s bullet. There was great doubt he would survive. Their hands were shaking. They were about to cut open the President of the United States!

In the OR Reagan raised himself up on one elbow, moved his oxygen mask so he could speak, and said, “I hope you’re all Republicans.” The unbearable tension was broken as they burst out laughing. Dr. Benjamin Aaron, a liberal Democrat, assured him, “Today, Mr. President, we’re all Republicans.”

Humor can help in ordinary arguments, too. A fellow mediator tells this story: She was getting nowhere with two parties who kept insisting, “I want this” and “I want that.” No one would move. Annoyed, she said, “Well, I want George Clooney naked on a beach, but we don’t always get what we want!” That cleared the air!

A couple of things to note: the butt of the joke should be the teller, not the listener. That’s obviously true of the second joke. But even Reagan’s comment is also self-deprecating, in that he acknowledges – in jest, but with a tinge of reality — his own fear and insecurity.

The second point: it allows everyone in the room to recognize their common humanity. My enemy is laughing and so am I. Both of us may be unrealistic to think we can always get our way . . . or, in Reagan’s case, we’re all vulnerable human beings whose deepest need in distress is compassion and care. We’re all in this together.

Breaking the tension with humor opens everyone’s field of focus. It helps the parties move from fear and defensiveness to creativity, from competition to collaboration. It can move us from our snake brain where fear reigns, to our frontal lobes where problems can be solved.

So . . . next time the tension gets thick . . . remember to lighten up!

Carolyn

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Don’t Shoot the Messenger? Gimme a break!

April 30, 2012 By toughconversations Leave a Comment

I was recently asked to pass a message from one party to another. Party A didn’t want to confront Party B. Reluctantly I agreed to be the go-between. And as usual, I turned out to be as much the enemy in the eyes of the recipient as the person who asked me to relay her message.

Talk about a tough conversation? It was impossible. So, I decided to check in with an expert on messaging: the daughter of a divorced couple.

Even though most divorce agreements state that the parties will not ask their child to pass messages between them, it is honored more in the breach than in practice.

She generously shared her five rules for message transmission. With her permission I am passing them on to you.

1. Prepare to be shot. No matter how hard you try not to be in the line of fire you will likely be a target.

2. Try to impress on the recipient that you are in no way responsible for coming up with the message. Try even though you’ll probably fail.

3. Empathize with the recipient. Let him or her know that you understand how they feel; how difficult it must be to hear what you have to say.

4. Get ready to listen to the recipient’s vent. Sadly, your messaging job isn’t complete until you have duly heard the recipient blast away at whomever you represent as well as yourself.

5. Finally, proclaim your neutrality. It is critical that you tell the recipient that you don’t have a dog in this fight.

The best advice that I can proffer, however, is this:  unless you’re a trained mediator, refuse to be the messenger. Just say no.

Sig Cohen

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Breaking the Bad News (Cont.)

April 23, 2012 By toughconversations 2 Comments

Last week Sig asked: If you had a fatal illness, who should tell you? Your doctor?  A  loved one?

How should they say it?

My Dad, 93, was slowly dying. His body was riddled with the prostate cancer he’d lived with – and minimized — for 20 years. He’d signed an advance directive (“no extraordinary measures”) and a health care power of attorney. But he’d made clear that his own death was not a topic of discussion.

One afternoon he told us to call an ambulance. “I just don’t feel right,” he said.

Early next morning, in the hospital, he suffered a massive heart attack. A doctor met me in the hall. “He doesn’t know what happened. We don’t want to frighten him. There’s nothing we can do. We’ll make him comfortable. He might last 24 hours.”

I was sad but not surprised. Dad had fought the good fight. I went in to hold his hand.

He was alert, even cheery. He pretended nothing had happened. “I feel pretty good,” he said through his oxygen mask. “I hope the Redskins win tomorrow.” Denial, full strength. He was not going there.

But a few hours later he asked, “Why aren’t they treating me?”

I tried, “Well, Dad, maybe there’s nothing they can do.”

He was furious. “I’ll fire them and get a new doctor!” He tried to climb out of bed.

When a female doctor appeared a couple of hours later I privately asked her to tell him.

She was kind. She sat beside him, at eye level. She was indirect and used a lot of silence to let him absorb each sentence. She emphasized the things he could control.

“Mr. Miller, your daughter tells me you’re wondering about treatment.” Pause. He nodded. “You’ve suffered a heart attack.” Pause. Nod. “It wasn’t a little one.” Longer pause. “I’m afraid it did a lot of damage. . . . . . We can’t fix it.” A really long pause.

“And you know you also have cancer. . . . . that has spread,” she continued. “That’s why you can’t keep food down.” More silence.

Finally,  from Dad, “How long?”

“Not weeks.” [Her phrasing astonished me.] . . . . “Is there anything you need to do?”

Dad looked at me. “No. You’ll take care of Mom (in a nursing home with advanced Alzheimer’s), you know about the money . . .” Then he described the funeral he wanted.

The doctor told him he could choose hospice, he could control his pain medication, and he could decide whether he wanted to go home or stay where he was.

When she left, Dad said, “She said I have two weeks.” Nobody argued with him. He lived four more days.

Carolyn Parr

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Passing the Buck on one tough conversation

April 16, 2012 By toughconversations 2 Comments

Last week my friend Gail told me she was put into an extremely difficult situation. Her mother’s oncologist called Gail to inform her of her mother’s terminal cancer and asked Gail to break the fateful news to her mother. By way of background Gail and her mother live in different cities. And Gail’s mother had an appointment with the oncologist two days later.

What should one do in a situation like that? How ethical is it when your mother’s doctor relies on you to inform your parent that she has an untreatable cancer?

Isn’t it the doctor’s responsibility to do that? How should one frame a message that is so heart-wrenching as informing your parent that her days are literally numbered. Once you’ve taken that step and bravely, and perhaps tearfully, broken the fateful news, how do you respond to such questions as: How serious is the cancer? How long do I have to live? Are there treatments that will possibly cure, or if not cure, delay the inevitable? And worst of all, what should Gail’s reply be if her mother asks: “What do you think I should do?”

Well, Gail broke the news to her mother. It couldn’t have been easy telling your parent that she is going to die…soon. Gail also promised to come home to accompany her Mom to her appointment.

Gail’s mother received the news with equanimity. Knowing that Gail’s knowledge was limited and that she had an appointment with the oncologist two days later, her mother had only one request of Gail: that she be strong because she would need her daughter’s fortitude and love more than ever in the months to come.

Sig Cohen

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Writing in Pencil

April 9, 2012 By toughconversations Leave a Comment

Some agreements ought to be in black and white, airtight, every possible contingency nailed down. High-conflict parties, threatening to derail a truce at the drop of a comma, need to consider and resolve every hypothetical uncertainty. Where trust is low and anger palpable, writing in ink may be their last chance to avoid court.

But when family members — with admittedly different interests — genuinely want what’s best for their children, siblings, parents (or even each other) it’s sometimes best to “write in pencil.”

Not the kind with a lead point. I’m talking about room to explore possibilities on a temporary basis before making a firm commitment. It’s often easier to agree to try something if you know you’re not irretrievably bound.

In mediation this can be done a number of ways:
–language that affirms trust and a mutual desire for flexibility (“The parties are working well together and believe they will be able to informally resolve any changes that may need to be made in the trial plan…”);
–a clearly defined trial period (90 days? Six months?);
–a written commitment to return to mediation if something doesn’t work or needs tweaking;
–compassionate provisions for contingencies such as illness, job loss, or transfer by a participant.

My friend Marilou and her siblings were worried about their 90-year-old mom living alone. Mom is mentally sharp and capable of managing her money, her meals, her life. She’s not ready to move. But as winter approached, the dangers of a fall on ice or power failure or Mom’s isolation in a snowstorm loomed large. She agreed to move into a senior residence just for winter, with the clear understanding she could return to her home in the spring. The kids kept the house ready, and brought Mom back to check on things whenever she wanted.

They were relieved to see their mother enter into the social life of her new residence. One day she said, “You know, I’m really enjoying this place.”

Whether Marilou’s mother returns to her own home and continues to use the senior residence for winters (sort of like “going to Florida”), or whether she decides to move permanently isn’t so important. However it turns out, everyone recognizes the choice is Mom’s, she’s willing to be flexible, and – most important — they can trust each other to work it out.

Writing in pencil works for this family.

Carolyn

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The Toughest of Conversations?

April 2, 2012 By toughconversations Leave a Comment

How do I want to die? Where do I want to spend my last days? And with whom? These are some of the questions thoughtfully posed by the award winning documentary, “Consider the Conversation.”  

This 2011 production is a rare find. Consisting of interviews with hospice workers, doctors, an ALS patient, and numerous others, it raises profound questions about how we both hope and plan to spend our final days.

In an accompanying study guide (www.considertheconversation.org) the producers state that their goals include changing the commonly held American view that end-of-life is a failed medical event rather than a normal process rich in opportunity for human development.

Second, they seek to inspire dialogue between patient and doctor, husband and wife, parent and child, minister and parishioner.

Third, they want to encourage medical professionals, healthcare workers, and clergy to take the lead in counseling others about end of life issues.

The documentary does not offer answers. Instead, it provides questions all of us need to contemplate and answer for ourselves. The film elegantly aligns these questions with the concept of advance care planning which is all about talking with patients and loved ones about their end-of-life wishes, documenting them, and taking action to ensure they’re honored.

Other questions the film asks are: At what point is the quality of life no longer worth the emotional and physical costs of maintaining it? When is it OK to acknowledge that one has fought the good fight and it’s now OK to accept moving to the next phase? Have we had a tough conversation with our doctor about end of life planning? Will our doctor be honest and courageous enough to tell us when there is no more she can do and not consider that a medical failure but a fact of life? When is enough, enough?

Every so often we find a resource that challenges us to engage in a Tough Conversation. So it was with Five Wishes which provides a caring and intelligent approach to creating a Living Will. How to Say it to Seniors by David Solie is another gem that guides our thinking about what it means to be an elder and how to communicate effectively with elders. And so it is with Consider the Conversation, a thought provoking journey into what too many of us consider taboo territory.

For PBS listing or to purchase the film see www.considertheconversation.org.  

Sig Cohen

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Stuck in Childhood?

March 26, 2012 By toughconversations Leave a Comment

In our mediation practice we sometimes see siblings who can barely be civil to each other. One says something that sounds innocuous to us, and the other flares up as if insulted. What’s going on here?

One of my favorite blogs (inward/outward.org), recently posted a quote from Madeleine L’Engle’s book, “A Stone for a Pillow.” Seems an 11-year-old girl asked her, “How can I remain a child forever and not grow up?”

L’Engle wrote back, “I don’t think you can, and I don’t think it would be a good idea if you could. What you can do, and what I hope you will do, is remain a child forever, and grow up, too.”

She adds, “That is what it means to be a whole human being, rather than an isolated fragment of our own chronology.”

In the presence of parents or siblings we’re always tempted to replay old tapes. The good news is, we can re-set the Play button. By paying attention to our inner thoughts and emotions, we can notice what’s happening, and then tell ourselves: That was then, and this is now. I’m no longer that child, and neither is my sister. I can (and will) choose to act and speak as the compassionate adult I have become, here and now – and maybe that will free her to do the same.

We don’t have to be stuck with childhood hurts. We can choose the road to wholeness and freedom.

Carolyn Parr

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But What About Me?

March 18, 2012 By toughconversations Leave a Comment

Last week my neighbor Phil told me that his mother in law recently passed away. After extending my condolences over his loss, I remarked that rarely had I seen such devotion as what his 17-year-old son Wyatt has felt toward his maternal grandmother. Throughout her bout of illnesses and a difficult passage to her death, Wyatt was always there for her.

Eventually our chat got around to her legacy. He said that his mother in law had left every thing to his wife Stella, her only child. He further commented that when Wyatt heard about her bequest, he asked: “But what about me?” Wyatt had spent time each day with his grandmother while she lived with them during the last two years of her life. Now that she was gone, what did he have to remember her by, other than memories?

Phil said that Wyatt was getting over his disappointment, and that he and Stella decided to allot a portion of the bequest for Wyatt’s higher education and a new laptop computer. But the hurt lingered.

How could this situation have been handled differently? Well, Stella and Phil could have talked with Stella’s mother and suggested that she leave something to Wyatt. It might have been a tough conversation….or not. Phil was sure that had they suggested leaving something for Wyatt, Gail would have agreed. But, sadly, no one thought of it.

This is our third blog that deals with holistic estate planning. As you can see, it doesn’t have to be a complicated process. But had a conversation taken place and Gail’s will included something for Wyatt, it would have had a profoundly positive effect on Wyatt for years to come.

Sig

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Looks Like a Beach House But It’s Really a Time Bomb

March 12, 2012 By toughconversations 1 Comment

You and your wife spent weeks every summer at the Delaware shore, and your three kids loved the place. Now adults with their own families, they still come bringing grandchildren and friends to your growing reunions. Of course, you assume they’ll want to continue this tradition. The thought of leaving it to them in equal shares after you’re gone makes you smile.

Wait!  You forgot something. You forgot to ask them.

At the reading of the will Karen (who married money) says, “I can’t really use the beach house since I moved to California. I’d like to sell my share to one of you and get something closer to home. Who wants to buy my share?”

“Buy your share!”  Joe explodes. “My business is in trouble. I need more income. I say we keep the house, rent it all summer, and use the income.” He glares at Karen.

Marianne, the youngest, is shocked at her siblings’ lack of sentiment. She loves the house and wants to spend much of the summer there. She’s a single parent and can’t afford to contribute to taxes, insurance, utilities, and yard service. So she’d like to mortgage the place and use her share of the cash to pay expenses and send her kids to college. She has a vague hope of getting a raise or a better job so she could help later with expenses and mortgage payments – but not now.

So . . . Karen sees the beach house as a California play space. Joe sees it as insurance to prop up his business. And Marianne sees it as a free vacation and college for her kids.

This kind of dilemma is very common and easily avoided. But that requires a conversation. It’s much easier to talk differences through with living parents present than in a post-mortem mediation or, worst case, a lawsuit. Sometimes the anger never goes away.

How much better if the parents had simply said, “We’re thinking of leaving you the beach house together. How might that work for you?”

Please, as you’re making your will, check out your assumptions about what your children want or need. You want to leave behind happy memories and love for each other – not a ticking time bomb.

Carolyn

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