Completing advance directives is an important part of advance care planning, but there’s another step people sometimes overlook: Talking to others about one’s wishes.

Adult children need to know what their parents would want if a debilitating illness strikes, according to Dr. Richard Payne, who leads the Duke Institute on Care at the End of Life.

Payne spoke to a breakfast crowd at Harper’s Restaurant on Jefferson Street during a recent visit to Nashville. The breakfast was hosted by The Gift Initiative of Alive Hospice, a community education program that was started to help adults plan for care in advance of illnesses and the end of life.

“As we think about what it means to grow as senior citizens gracefully, what we need to do is prepare ourselves and our families for situations where we may become too ill to tell doctors what our preferences for care are, and what kinds of things we want,” Payne said.

A 2009 Pew Research Center survey of adults aged 65 and older found that, while 76 percent had discussed wills/estate planning with their adult children, comparatively fewer had also discussed end-of-life medical decisions with their children. The study found that one in three people surveyed had not told their adult children what they’d want if they were unable to make medical decisions for themselves.

Payne spoke of heartbreaking conflicts between family members as they try to decide the course of action after a loved one has become ill. These conflicts can do lasting damage, he said, but they can be avoided if family members are informed in advance about what the patient would or would not want.

Completing a living will and appointing a healthcare power of attorney are very necessary, he said, but that’s not the end of the process.

“The key here is communicating. Putting the documents in place is important, but even more important is talking with your family and loved ones and designating someone who really will speak on your behalf,” Payne said.

Tips and tools for talking about advance care planning are available online at www.thegiftinitiative.org. Additionally, workshops on advance planning facilitated by The Gift Initiative may be requested online.