Many of us often associate the holiday season with happy, positive things: family get-togethers, gift-giving and, of course, food celebrations. We count our blessings, and we check in on loved ones. Those special family parties and meals can offer opportunities for sharing memories and making new ones. But a holiday spent with family members can also be a good time to have some frank, even tough conversations about family health.
Creating a family health tree can allow you to assess your own health risk factors and those of your kids and even their kids. In order to pull this off, you need to get your family members on board and willing to reveal information about themselves and prior generations. For example, if a disease “runs in your family,” then knowing about cancer or heart disease or diabetes in your extended family tree can be crucial to informing lifestyle change, as well as being proactive about the health of your family.
If any family members in your extended family have developed or dealt with recent health issues, convincing them to do a “reveal” can be hugely helpful in understanding family health and its evolving implications. Sharing the information with your primary care physician can help to determine the timeline for screenings and proactive lifestyle changes as a means of preventing or delaying disease.
There’s no “one size fits all” approach to instigating this tough discussion. If you’re dealing with your parents or grandparents, and you have children, consider presenting this as a family activity. Create a large family tree (including parents, grandparents, siblings, aunts, uncles, nieces, nephews, cousins on both sides of the family) and especially get senior family members to help fill in what they know about prior generations. This can be a several-day activity with storytelling along the way. Another tool is ItRunsInMyFamily which allows you to sign up for free and create a family history profile online, with input from family members. Or just start a gentle conversation with one or more family members, suggesting that family health knowledge offers power and that this knowledge is really important to you.
The Mayo Clinic suggests some “best practices” for gathering family health information:
Share your purpose. Make sure to convey the idea that sharing this information will benefit current generations and future generations.
Provide different ways for individual members to answer questions. Some may feel comfortable in this group setting, while others may want to talk to you one-to-one.
Keep questions short and to point. Some family members may need to ramble or reminisce so be prepared that this effort may take time.
Be a good listener and don’t judge. You may disagree with health decisions that family members made (hiding disease for years, not treating conditions). Remember that the purpose of this exercise is to “get information” that can benefit the whole family and generations yet to come, not to make judgements.
Respect privacy. Some members may be willing to reveal information to you but may not want family members to attribute that information to them directly. Be willing to compile information with some privacy parameters.
Ask specifically about individual types of cancer, hypertension, heart disease (heart attacks, strokes, and cholesterol issues), kidney disease, diabetes (type 1 and type 2), mental illness, neurological illness, skin diseases, respiratory illnesses (asthma). You can use the My Family Health Portrait tool as a guide.
Remember that a wealth of information may exist in old family bibles, existing family trees that previous generations may have made, old letters, obituaries, records from places of worship, and public records (birth certificates, marriage licenses, death certificates). More recent electronic health records can also fill in gaps. For each person include sex, date of birth, ethnicity, medical conditions, pregnancy complications, age when diagnosed, lifestyle habits (alcohol, smoking) and for deceased relatives, age at time of death and cause of death.
Pay special attention and highlight health situations like early death (before age 60) from heart disease or the development of diabetes type 2 in youth or young adulthood. Make this an ongoing yearly project so that as children are born or medical conditions are diagnosed, you keep updating the family health tree. Share important milestone health updates with family members and healthcare providers.
According to The Conversation Project, 90 percent of people say that talking with family about end-of-life care is important and 27 percent say they haven’t actually done so. Of course, if a close family member has a very serious or terminal illness, then time is of the essence. The holidays may help to ease the difficulties surrounding this very difficult conversation. If your family member feels surrounded by love, it might ease the entry into the discussion. It is also a good time to have some discussions with all close family members about what they would want if a sudden acute health issue or traumatic health event occurred or if there was slow, steady mental or physical health deterioration. Start a conversation about creating a living will and end directives. There are so many specifics to discuss about how aggressive (or not) the patient might want you to be, and some of the answers may surprise you.
Be proactive and have the tough conversations about health. There’s a beneficial health payoff for the whole family. It’s a gift for all!