Q. I am very close with my in-laws, who are both in their late 70's, and all I want for them (and for everyone I care about) is to live a long happy life.  Unfortunately, the inevitable happens to us all, and when it does happen, I really want my entire family to be prepared ahead of time. However, in the case of my in-laws, this has been a really difficult task.

Whenever my husband and I bring up advance directives and end-of-life planning, my in-laws are completely averse to having the conversation, because it is too "depressing." They change the subject every time. One Thanksgiving, my father-in-law confided in me that he would want to be taken off of life support should he become incapacitated and end up in a coma. I know that if there are no documents in place, my father-in-law's wishes might not be met should the situation arise. 

My in-laws were huge Joan Rivers fans.  Do you know if Joan did end-of-life planning?  If so, and if it helped Melissa, maybe I use the example of Joan Rivers as a way to get my in-laws to have the end-of-life conversation that we so badly need to have.

A. Unlike so many of us, Joan Rivers was not uncomfortable talking about growing old or dying.  She told many jokes about death, and losing her memory because of aging was one of her favorite sources of comedy material. Joan's willingness to make light of aging and dying almost made it appear that she would be immune to it.  Unfortunately, nobody is immune, but in Joan's case, at least she was prepared.

All the jokes Joan Rivers told and everything she did to defy aging did not hide the fact that she was ready for the inevitable.  In fact, in recent TV tributes from her reality show from earlier this year, she earnestly pled with her daughter, Melissa, to be ready in case she did not make it out of an upcoming surgery.  Rivers told her daughter, over and over, that Melissa and Joan's grandson, Cooper, would be fine when the day came.  Rivers attitude was that she had a remarkable life, even if it ended that day.

Joan Rivers died on September 4, 2014 at the age of 81, and based on her brilliant career and advanced planning, it is evident that she was smart, savvy, and that she made her end-of-life wishes well-known. When Melissa Rivers gave the final direction to take Joan off of life support, it was because Melissa knew for certain that Joan would not have wanted to stay on life support given the situation, because Joan had clearly expressed her wished ahead of time.

Talking about end of life issues is an emotional and difficult task for most of us, but it's a vital first step to making sure your wishes are clear. Did you know that 60% of people say that making sure their family is not burdened by tough decisions is "extremely important," yet 56% have not communicated their end-of-life wishes.  A conversation, followed by incapacity planning, can make all the difference, but must be done before it's too late.

As you have experienced with your in-laws, it's not easy to talk about how you want the end of your life to be. But it's one of the most important conversations you can have with your loved ones. How do you get started? Below are some helpful resources:

You can always use the story of Joan Rivers to spark the conversation that may encourage your in-laws to stop procrastinating and finally take action.  And, as Joan taught us, it's okay to use humor even when talking about this difficult subject.  In fact, doing so may make it a little bit easier.

As Joan Rivers said, there is no need to be afraid of dying.  It will happen, and it will undoubtedly be a sad and stressful time for the loved ones you leave behind.  So why not make it as easy on them as you can? Once you have taken the step of speaking with your loved ones about your wishes, it is important for them to sign Incapacity Planning documents, including an Advance Medical Directive and General Power of Attorney , to make their wishes legally enforceable. Once your in-laws are ready, have them call us at our Virginia Elder Law Fairfax office at 703-691-1888 or at our Virginia Elder Law Fredericksburg office at 540-479-1435 to make an appointment for a no-cost consultation.

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Dear Saki and Alley,

My children (ages 10 and 14) and I recently went to visit my mom in her nursing home.  Mentally she's still pretty much fine, and she's in the nursing home because of physical problems.  My mom doesn't complain, but she seems bored, and she clearly misses her home. We live 600 miles away. Is there anything we can do to help alleviate her boredom and make her feel more at home?

Thanks,

Maura Tome

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Dear Maura,

Patients in a nursing home are often limited in their mobility as well as in their contact with the outside world, which can often cause feelings of isolation or depression. Spending long days watching television and waiting for the next meal is a mundane and boring existence for most adults (even though this may sound like heaven to your teenager).  However, there are a few ways for family members (even those who are far away such as you), can help alleviate the boredom and improve the mood of a loved one in a nursing home:

• Call when you can and put the grandchildren on the phone. Try calling at around the same time so she knows the call is coming (after dinner, for instance and before she goes to sleep) and has something to look forward to. If she is technologically savvy, you and the grandchildren can even Skype with her.
• Next time you go, give her a tablet such as an IPad so she can watch YouTube videos, listen to her favorite music, surf the web, download apps, and play games. Enlist your teenager (or even your 10-year old) to teach grandma how to do these things if they are unfamiliar to her.
• Send care packages to your mother with things to remind her of her favorite comforts, including framed photos, her favorite sweets and treats, greeting cards, or a mini Christmas tree or Menorah if it is around the holidays. Send something whenever you can to lift your mother's spirits.
• If you don't have time to make the care packages, sign your mom up for a "Gift of the Month" club. A great way to start is the website http://www.amazingclubs.com, which lists 39 different "Gift of the Month" clubs that will deliver goodies such as cookies, cakes, chocolate, cupcakes, cheese, fruit, popcorn, and jams and jellies. If food isn't her thing, then there are also "Gift of the Month" clubs that will deliver things like flowers and teddy bears.

Exercise is also helpful in enhancing the mood, but also overall feeling of well-being. While many seniors and nursing home residents are not be able to participate in a traditional exercises, there are stretches and chair exercises that can be modified to work with many facility residents. By participating in exercise programs, the extra movement as well as the camaraderie and companionship found in a small group setting, facility residents can alleviate their sense of boredom and isolation. Establishing relationships with those around them can be a comforting and rewarding experience for any person, regardless of their age or physical abilities. Be sure to discuss the options regarding exercise with your mother's case manager.

Many Purrs,