"Mom, can we not do this right now? You're healthy, and I really don't want to spend our time together talking about worst-case scenarios."
I’ve had a number of conversations recently where older adults want to talk about their values for end-of-life care, but their adult children are resistant. It got me thinking about ways to help bridge that gap in families.
Instead of starting with "We need to talk about my end-of-life plans," parents might invite conversations grounded in love, preparation, and mutual care. That tends to reduce the chance that the adult child immediately hears, "Mom is talking about dying," and shuts the conversation down before it begins.
It helps to stay focused on shared goals by framing the conversations as gifts, not burdens.
“My hope in talking about these things is to make things easier for each other, not make anyone feel worse right now.”
Resistance on the part of adult children is often rooted in emotion rather than a lack of caring. These discussions can force them to confront the reality of losing a parent, making mortality feel more immediate and real. They may also signal an uncomfortable shift in roles, from being cared for to becoming a caregiver or decision-maker. For some, discussing illness, decline, or death feels like acknowledging something they are not emotionally ready to face. Practical conversations about medical preferences, living arrangements, or legal planning can also trigger guilt or anticipatory grief, creating the feeling that they are preparing for a loss before it has occurred. We also see in many families that communication patterns, differences in values, and varying levels of emotional readiness can contribute to avoidance or procrastination.
So how do we talk in gentle ways with families about anticipatory grief or the fear of emotional pain? We might start with normalizing why these conversations can be hard.
“I think sometimes we avoid these talks not because we don’t care, but because we care so much that it can feel overwhelming.”
This is likely to reduce defensiveness, as people are much more open to looking at something when it isn’t framed as a flaw.
We can bring in the experience of grief without sounding too clinical or analytical.
“I read something recently about how people can start grieving before anything has actually happened—just because they know it will someday. It made me wonder if that’s part of what makes this so uncomfortable for all of us”
You don’t even have to use the term unless they’re receptive. If they are, you can name it simply:
“Some people call that anticipatory grief.”
The goal is not to force a difficult conversation, but to create enough safety and understanding that people can engage with it at their own pace. Small, ongoing conversations focused on shared goals and support are often more effective than trying to resolve everything at once. And if the adult children still resist, the parent can respect that boundary but leave a gentle opening.
“Okay...We don’t have to talk about it now. Just know it’s something I’d like us to be able to come back to again—even if it’s just a small piece at a time.”
Preparation for end-of-life care within families requires acknowledging a future reality that they may not yet be emotionally ready to face. End-of-life conversations are often viewed solely as discussions about loss, decline, and death. We can offer guidance for starting conversations that focus on values, relationships, and quality of life. By broadening the discussion beyond what may change or be taken away, these conversations create space for families to reflect on and communicate what matters most.
