Most people wish they felt more comfortable talking about their healthcare and funeral wishes as they near the end of life. Learn about how to give this gift of information to your loved ones.
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A Gift to Your Family: Explaining Your Wishes

Kristin Scheeler, MSSW, CAPSW, OSW-C
Kristin Scheeler has 20 years of experience as a master’s level social worker. Her experience includes working with older adults, in hospice, in cancer-care settings, as a health insurance care manager and now as the owner of Madison Care Management, a private social work patient advocacy agency. She received her training at UW-Madison and has a passion for assisting those facing the end of life.
A Gift to Your Family: Explaining Your Wishes
Maggie McKay (Host): Welcome to Stoughton Health Talk. I'm your host, Maggie McKay. Today, Kristin Scheeler, Master of Social Work, Certified Advanced Practice Social Worker and Primary Independent Patient Advocate for Madison Care Management is going to tell us how to deal with the difficult journey of a loved one's end of life. Thank you so much for joining us today, Kristin.
Kristin Scheeler, MSSW, CAPSW, OSW-C: Well, thanks for having me. It's a pleasure to be here.
Host: So what kinds of things are important for people to talk about when a loved one is advancing in age or nearing the end of their life?
Kristin Scheeler, MSSW, CAPSW, OSW-C: Well, I kind of think of maybe three different buckets of information that people might want to consider talking about. So first of all, their health. What diagnoses, if any, do they have? And what does that mean in terms of progression? Like what might they be facing over time in terms of symptoms or the way the disease progresses.
And then so along with that, what kinds of treatments would somebody want? What would they want in terms of quality of life? Is quality of life more important than quantity of life? And for every person, that's a different answer. Then finally in that health bucket, I would also make sure that people have assigned a healthcare proxy for themselves.
So usually a healthcare power of attorney, an agent on the healthcare power of attorney, who would make the person's decisions for them if they became unable to make them for themselves. So lots of conversation about health. The other things that might be of interest to people who are getting older or facing end of life, are funeral plans. So whether that's prepaying for a funeral or deciding music, readings, location for a celebration of life, those kinds of things. And then also just personal items. So clearly, it's always good to have some kind of estate plan in place that you can do with a lawyer, or if needed, you can do them sometimes on your own as well.
But if you have special items, jewelry, antiques, things like that. You can put people's names on them, and designate who they might go to. That might help in the long run, especially if you have varying personalities in your family.
Host: So facing your mortality is rough. How do families get these conversations going?
Kristin Scheeler, MSSW, CAPSW, OSW-C: Well, there's kind of a joke in my professional circles that you bring this up at Thanksgiving, but I would say that might work for some families, but really planning a time to discuss all of this tough stuff so that you're setting the stage and the intention that that's what you're going to be talking about at this moment in time.
People can then come prepared to talk about end of life or getting sick or people making decisions and they'll be ready for it. And then the other thing is to make sure that everybody who might be interested in this discussion, is there all at the same time. So whether that has to be done by phone or video to include everybody that you want to include, I would always suggest that everybody hears the same message from the loved one all at the same time.
Host: How do families cope with the uncertainty of knowing the exact medical situation their loved one might be faced with if medical decisions need to be made for them?
Kristin Scheeler, MSSW, CAPSW, OSW-C: So you don't know if you're going to need a ventilator or some other life sustaining measure taken on your behalf, and there's no way you could possibly talk over every scenario that might come up. So that's why it's really important to know your values. What has always been important to you in your life? What's important to you now and what do you think will be most important to you as you near the end of your life? And then make sure that your family knows all about that.
Host: Kristin, what are the four things that matter most? Let's narrow it down.
Kristin Scheeler, MSSW, CAPSW, OSW-C: Yes. There's a palliative care physician named Ira Byock, who wrote a book about 10 years ago called The Four Things That Matter Most, actually, I think it's older than 10 years now. And he wrote it after reflecting on many conversations that he had with patients who were nearing end of their lives.
And the four things that he came across, over and over and over again, boiled down to these four statements. Please forgive me. I forgive you. Thank you. And I love you. So most things that you can think of will boil down to one of those statements. In fact, he even advised the showrunners of The Pit and they did talk about the four things in that TV show.
Host: I knew I heard that somewhere, Kristin.
Kristin Scheeler, MSSW, CAPSW, OSW-C: Yep, yep.
Host: Wow. Okay. Say it one more time.
Kristin Scheeler, MSSW, CAPSW, OSW-C: I forgive you. Please forgive me. Thank you. And I love you.
Host: Have you seen people use those in your practice?
Kristin Scheeler, MSSW, CAPSW, OSW-C: I have, and I've actually advised people to use them long before The Pit. I worked in hospice at one time and I found it very useful there. People can always find a way to apply it.
Host: And why might funeral planning before someone's death be important for some families?
Kristin Scheeler, MSSW, CAPSW, OSW-C: Well, as you probably know, when somebody dies, it's a really emotional, difficult time. It's hard to think. It's hard to make decisions, and there's about a thousand decisions to be made, and it's a gift that you can give your family to pre-plan your funeral. It gives them some level of certainty when there's no certainty about life.
When there's no clear path forward, it can give them one thing they can do to honor your wishes one more time. They can make sure that reading that you so cherished is read, the music that you loved gets to be heard one more time from that lens of, oh Mom or my sister or whomever really loved this song.
And it could reduce some friction between family members if there's any disagreement about what to do. So I would advise writing down your wishes, including the readings and songs and the location, and then also the type of disposition for your body. So whether that's a burial or a cremation, write that down too. Or more specifically, even it's a green burial, write that stuff down and make sure that all interested parties have access to the document so that they can see that the clear path forward to honoring your wishes.
Host: Right? Because the more kids you have, the more complicated it gets. The siblings, you know, people can't agree and they're like, oh no, mom said this. No, she said that. Anyway, anything else in closing that you'd like to add?
Kristin Scheeler, MSSW, CAPSW, OSW-C: Just in general, the conversation is so important. We need to make sure that we're always having an ongoing conversation, especially when someone's getting older or end of life is approaching. Sometimes you learn something new and it changes your perspective on things. So continuing to have the conversation is the most important thing to keep in mind when you're having any discussion about anything serious. Keep that conversation going.
Host: Absolutely. Well, thank you so much for helping us understand this topic that will affect all of us at some point.
Kristin Scheeler, MSSW, CAPSW, OSW-C: It will, and you're welcome and thank you for hosting me.
Host: Absolutely. Again, that's Kristin Scheeler. To learn more, please visit madisoncaremanagement.com, or stoughtonhealth.com. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Stoughton Health Talk.