On Sunday we acknowledge the noble role of motherhood, which is easy. Mothers are the givers and guardians of life. They not only risk their own lives to create new ones, but nurture and care for their families -- for generations -- and selflessly address their own needs last. As a mother, I've realized so much of what we do isn't because we're the only ones able, nor because we actually want to. Rather we are often the only ones who anticipate problems and actually see what needs to be done.
Mothers make the pediatric appointments, pick up the dry cleaning and put away the holiday decorations. It follows logically that mothers are also the most likely to take on difficult end-of-life responsibilities for their parents, spouses and other loved ones. And they do. Though we give the gift of birth and life, death and dying are also very much mothers' issues. We are often the ones who make healthcare choices for those we love, when they no longer can.
But our natural affinity is only part of the reason. The fact is, women live longer. On average, we live six years longer than men. And most states designate a dying patient's spouse as the decision-maker in the absence of an appointed agent or proxy. Most married women outlive their spouses. The maternal tendency to take care of others means the last face each of us is likely to see as we die is a woman's.
I certainly don't suggest forgoing the flowers and brunch this Mother's Day. But maybe this year we can also present mom with some reassurance that she alone will not carry the burden of difficult end-of-life decisions. Give mom the comfort of knowing others have expressed their values and preferences. She can simply act as a spokesperson instead of decision-maker for the issues that come up if a loved one is dying.
Talking about these matters is not necessarily grim. The conversation can lead to important discoveries and closer connections with the people you love. Your mother will appreciate knowing the family she raised is strong enough to discuss death calmly and consider what makes a "good death."
Although it may be against a mother's nature, make sure she outlines wishes for the last person a mom usually considers -- herself. Have your mother explain her end-of-life values and choose an appropriate person to be her healthcare proxy. Proxies are especially important for women, because older women are less likely to receive adequate pain medications. Up to 40 percent of female patients with pain management needs receive ineffective medication or none at all. Mom needs a strong advocate to save her from unnecessary suffering. The vast majority of Americans 85 and older are women, with nine out of 10 widowed. So sadly, she can't count on dad as a default.
Daughters, sons, husbands, grandchildren: This year urge the mothers in your life to answer questions and communicate wishes to ensure a death that honors the life they've lived. Discuss how they would want to be treated in a variety of situations, what they would prioritize if they were living with physical pain, terminal illness, dementia or debilitating chronic illness. Ask who should make decisions if they no longer can.
We've assembled the documents, guidelines and instructions you need for thorough end-of-life planning in the Compassion & Choices' Good to Go Resource Guide and Toolkit available on our web site. There's even a "Healthcare Decisions Game" to get the conversation started. Just as importantly, plan that path for yourselves -- all of you, any age -- to keep one tough task off mom's to-do list.