‘Don’t wait til 2am in a hospital corridor’: The five questions every adult needs to ask their parents

Kerry Milligan didn’t just plan for her mother Emmie Silbery’s death, they joked about it.

“I used to say she’d get a state funeral because Australia loved her,” said Milligan, who, with Silbery and her daughter Isabelle, were favourites on the Network Ten show Gogglebox.

Milligan, 72, was Silbery’s carer for seven years before her mother passed away in July.

“I had everything in place for her, from her advanced care directive to her will and power of attorney,” Milligan said. “Everything ran reasonably smoothly because we planned well ahead.”

Silbery is firmly in the minority. Just 14 per cent of people over 65 have advance care directives. Milligan was one of them.

“I was too busy looking after Mum, I didn’t finish putting anything in place for myself,” she said. Until now.

Milligan sat down to answer five questions designed to help the adult children of ageing parents have one of the most important conversations of their lives, which many find too frightening or difficult to start.

The questions are part of a new guide called “Put The Kettle On” from Vera, an online platform to support the “sandwich generation” of adults who are simultaneously caring for ageing parents and children.

The guide offers families a gentle “in” to a conversation less about end-of-life and more about what it means to their parents to live well in their last decades.

Each question comes with follow-up questions if they are needed, such as: “What are you most proud of?”, “If you needed more help over time, what would be OK?” and “Is there anything you’d be worried people who love you might get wrong about what you actually want?”

Almost 60 per cent of Australians aged 45 to 70 are caring for ageing loved ones or expect to be within five to 10 years, and 88 per cent feel unprepared or overwhelmed by caregiving demands, suggests a survey of more than 1000 Australians commissioned by the Vera-affiliated organisation Violet.

Melissa Reader, Vera’s founder, said adult children often found it frightening or too difficult to broach the topics, “so people end up having these conversations and making important decisions at 2am in a hospital corridor because Mum or Dad has had a fall or an emergency presentation”.

Clinical psychologist Jo Lamble, who devised the questions, said most people who try to talk to their parents about end-of-life will start with heavy topics such as their will or power of attorney.

“It can feel like the adult child is working out what’s going to happen with their money,” she said. “We want to start off really positively and signal that this is about hearing what you want.”

Research shows family conflict can increase the likelihood of inappropriate end-of-life care.

“We’re trying to lighten the load by saying that if you start having these conversations early and in a relaxed way, you can collate the information, share it among the family, then put it away, and it’s done,” Lamble said.

Roughly 70 per cent of Australians want to die at home. About 14 to 17 per cent do so.

Around half of all Australians die in hospital, and a large proportion are frail and elderly, “many are probably receiving low-value care”, Reader said.

Reader said people were applying for at-home care too late and joining long waitlists instead of introducing services earlier, such as gardening or cleaning. It can still meet resistance, Reader said, but it gives parents a chance to get used to the help before their health needs increase.

For Milligan, some decisions were easy, like her power of attorney: her daughter.

“If Isabelle deems that I am beyond salvation, so to speak, ‘Knock me off, darling. Send me away to the fairies’,” she said.

Other questions stumped her.

“I realised I wasn’t at all that prepared,” she said of the experience recorded for the podcast Club Sandwich, with journalist Sarah McDonald.

“It can be confronting thinking about your end of life and what you want … we really don’t get the chance to stop and think about it like this,” Milligan said.

Lamble said don’t wait: “Do it early and do it gently. It will make life so much easier down the track.”

Dr Wei Lee, palliative physician at Sydney’s Mater Hospital and MQ Health, said: “Oftentimes, elderly patients will say ‘I don’t want my children to know … I don’t want to be a burden to them’.

“But involving children in conversations when you are still competent means they will know your wishes and drive them through.”

Avoiding the stress of complex decision-making allowed children to focus on being present with their parents, which lessened the risk of complex grief and bereavement, he said.

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