If you need to have a discussion about end-of-life decisions.

Even if demonstrators intellectually understand their own mortality, they tend to feel like they’ll live forever. Since decisions like living wills or long-term care involve focusing on the negative and dealing with uninteresting details, they’re not likely to plan for these contingencies unless someone else encourages them to get started. On the other hand, demonstrators hate disappointing or inconveniencing others. To get a demonstrator to make end-of-life decisions, you may have to make it about you, not them.

Emmanuel’s health was failing, and he was spending more and more time in the hospital. Abigail worried constantly about what would happen to him in the long term. Her grandfather had given her medical power of attorney because, as a nurse, she was “so good at understanding all of that medical stuff.” He hadn’t ever mentioned what his end-of-life wishes were. In fact, even at 90, he hardly seemed to recognize that no one lives forever. Abigail wanted to make sure that she’d be able to follow his preferences and respect his wishes, but how could she do that when all Emmanuel wanted to talk about was the concert he was attending next week or the cruise he hoped to take next year?

Abigail knew that the only way to get her grandfather to focus on what he saw as boring and unimportant details was to address end-of-life planning from a perspective of her needs and her feelings. “Grandpa,” she said, “I need to know how you want to deal with a heart attack or a stroke. What if they need to restart your heart or put you on breathing machines? What about medications?” Emmanuel frowned. So many details. “Just keep me alive until I’m dead,” he said. “No, Grandpa, I need to know. If something happens and I make the wrong choice, I will be miserable. I will never forgive myself. I need your help to figure all of these things out. I can’t do it alone.” Emmanuel agreed that they could sort his end-of-life plans out right away—maybe over coffee at his favorite neighborhood café.

If they are in denial or ashamed of their condition.

The mantras of a demonstrator are “Everything’s fine,” and “Things turn out for the best.” This can be a great help when it rains on a day when a picnic is planned, but it can be a disaster when a demonstrator faces a serious medical crisis. Their tendency to ignore the negative and focus on the here and now can mean that they don’t get worrisome symptoms checked out in time. As a loved one, you may find yourself in the position of an advocate who must help them get the healthcare they need.

Araz first noticed the mole when he and his dad were golfing on a warm summer day. “Dad, what is that thing on your arm?” “It’s just a mark of some sort,” his dad shrugged. “I don’t know where it came from. I should probably get it checked out at some point, but it will probably clear up on its own.” Araz looked in horror at the black and purple, irregular spot. “Is it growing?” “No idea. I don’t really think about it that often. Hey, look at that heron over there! Lovely bird. Your mom used to paint them.”

Araz groaned inwardly, but tried to calmly redirect the conversation. “The thing on your arm. Have you shown it to a doctor?” “It doesn’t hurt. What’s the worst it could be? It’s probably just a cyst or an allergy or something.” Araz pulled out his cell phone. “Let’s call your doctor and make an appointment right now.” After they booked the appointment, Araz let the matter drop. They could talk about it later, after his dad had seen the doctor, and harping on the mole and his dad’s irresponsibility wouldn’t change anything. Besides, his dad was already back to pointing out birds.

If you think they need to see a specialist.

Demonstrators are usually not big fans of the doctor’s office. Time spent sitting in waiting rooms and alone in examining rooms is time that they don’t get to spend visiting with friends and family, exploring their communities, or helping others. Since demonstrators are extroverted people-pleasers, quiet activities that focus on self-care are near the bottom of their to-do lists. If your loved one is a demonstrator, she’s likely to put off making specialist appointments because they sound difficult and uninteresting. However, simple nagging won’t motivate her. To help a demonstrator see a specialist, you’ll need to take a more hands-on approach.

Siobhan knew her older sister was due for an echocardiogram. Their family had several congenital heart defects that needed annual monitoring that could lead to problems in old age. However, every time Siobhan asked, her sister responded with, “Oh, I haven’t gone yet. I have to remember to make an appointment one of these days. My calendar is so full, though! I’m not sure I even have time!”

“I’ll help you,” Siobhan said. She fixed a cup of tea and sat down with her sister at the table to update her calendar for the next 4 months. Then she dialed the phone and handed it to her sister. 10 minutes later, the appointment was booked. “Whew. That was easier than I expected,” her sister said. “And since I have to go into the city anyway, I can call up an old friend and we can go shopping after I get out of my appointment!”

If you think they’re having problems with their medications.

Demonstrators tend to focus on the positive. They forget about mild annoyances as soon as they’ve passed, and they’re so outward-looking that they don’t always notice what their bodies are doing. One doctor commented that people of this personality type are “like lizards. They seem completely well and happy right up to the moment where they’re so sick they need to go into the ICU.” This means that you, as a caregiver or loved one, may notice bad side effects of medications before your demonstrator does. You’ll then be faced with the task of making sure that your demonstrator reports the bad effects to the doctor. However, since demonstrators hate to disappoint or criticize, they may try to avoid starting what is, for them, an extremely uncomfortable conversation.

Sumitra’s mother stood up from the breakfast table and grabbed her chair for balance as her daughter sprang to her aid. “Mom, what’s going on? Are you all right?” Her mother was quiet for a moment, then stood up straight and let go of the chair. “I’m fine. I just get a little dizzy sometimes. It’s no big deal.”

“How long has this been going on?” “Oh, since I started that new medicine, but it’s listed as a possible side effect, so there’s no point in bothering the doctor.” “He needs to know you’re having side effects, Mom!” “They pass. It’s no big deal. I just have to pay attention when I stand up.”

Sumitra knew her mother wasn’t going to call the doctor about the dizziness, and that she’d never bring it up in an appointment. She offered to go along to her next appointment, but her mother said she’d be fine. Sumitra took advantage of the fact that the doctor’s office allowed email contacts. She emailed the doctor and his nurse a note that said, “I know you can’t respond because of HIPPA, but my mom has been having dizzy spells ever since you put her on that new medication.” At the next appointment, the doctor was able to start a conversation about side effects because Sumitra had let him know about her mother’s problem.

If you think they don’t understand their diagnosis or aren’t following their doctor’s instructions.

Demonstrators really and truly mean to follow doctors’ orders. After all, they love praise and hate conflict. It’s just that sometimes the doctor orders treatments that don’t fit with their spontaneous, active lifestyles. Medication regimes, special diets, and carefully arranged exercise programs can all fall by the wayside when a demonstrator is involved. The worst is when a new medication gets added to the mix, and needs to be taken at a weird time. Demonstrators may be able to embrace the routine of breakfast or bedtime medications, but anything more complicated can become a major stumbling block.

Langston’s eye doctor was unhappy with how his glaucoma was progressing and had just prescribed a new kind of eye drops that he needed to use every 6 hours. Initially, Langston decided he’d put them in at 6 am, noon, 6 pm and midnight. The 6 am and noon times weren’t a problem for him. He could remember breakfast and lunch. He set an alarm for midnight and would wake up and use the drops. The problem was the 6pm set of drops. 6pm was right in the middle of when many of his social clubs met. He was out of the house almost every evening at that time, and he never remembered to bring the drops along. By the time he got home, it was too late to take them, because they’d interfere with his midnight drops.

Roxy found out about her uncle’s problems when she went to a community band concert. He asked her what time it was, patted his pockets nervously, and then cursed because he’d forgotten his danged eye drops again. Roxy was upset that her uncle wasn’t following the eye doctor’s orders, but she didn’t yell at him or threaten him with blindness, since she knew conflict would crush him. Instead, she focused on the positive. “You know, your doctor thinks those drops will be really good for your eyes. Let’s see if we can get you a second bottle that can just stay in your coat pocket.” After talking to the doctor, Roxy and Langston were able to get a prescription for the second bottle. While he didn’t always take the drops right at six, he usually remembered them before 7 and he always had them with him.

If you think they’re not taking proper care of themselves.

Demonstrators aren’t known for their routines or their attention to detail. Because they’re focused on pleasing other people, they’ll often neglect their own health during a family crisis. As a family member or other caregiver, you may need to remind them to stop focusing so much on others and to take some time for themselves.

Xavier’s dad had to move into a skilled care environment because he’d fallen several times, and Annamaria, his wife, couldn’t get him off the floor on her own. Annamaria continued living in her house, and drove to the skilled care facility daily, spending hours with her husband. She made sure he ate his meals and took his medicine, accompanied him to physical therapy, and took him out to church and the barber. Meanwhile, Xavier noticed that his mother was looking frailer, more tired, and a lot thinner. One day, he stopped by her house. He walked over and looked in the refrigerator. It had always been overflowing with food before, since his mother loved entertaining friends and family. Now, it was empty except for half a container of sour cream, a jar of mustard, and some moldy ham.

“Mom,” Xavier asked, “are you even eating anymore?” “Oh, I got a milkshake on my way home.”  Annamaria responded. “I don’t really feel like cooking if I’m home alone, and I’m so busy, I don’t have time to shop!” “What did you have for lunch?” “Oh, I grabbed a can of soda and a candy bar from the machines at dad’s nursing home.” Xavier knew he’d have to do something to get his mom back on track, or he’d have two parents in skilled care. Since he knew that his mom thrived on social contact, he arranged for each of his siblings and some of her older grandchildren to call her up one or two days a week and invite her out to lunch. By timing the invitations during his dad’s nap time, Xavier ensured that his mother had at least one good meal a day. The lunch dates also improved her stress levels and gave her the mental space she needed to start taking care of herself again.

When you think they need extra help.

Demonstrators need to move, go, and explore. They hate feeling tied down by schedules, which can be a big problem when they need extra help to deal with health concerns. While they won’t resent the presence of a home health aide, they may well resent having to be home to meet them every day at a set time. You can smooth over some of the friction by focusing on the social aspects of having a regular ‘date’ with home health.

Deon’s mother had a choice. She could go into the hospital for two weeks as an inpatient, or allow a home health nurse to come daily at 11am to give her an infusion. It would keep her out of the hospital, but she was skeptical. “That falls right in the middle of my morning! I can’t be home at 11 am every day! I’ll miss my Red Hat luncheon. And what if the weather is pretty? I’ll be stuck at home! This is ridiculous. They need to come earlier or not at all. I can skip the infusions. I’m on the mend anyway.”

Deon knew that if his mother refused at-home treatment, her doctor would admit her to the hospital, and then she’d be really miserable. “Look, I know these infusions are going to be a pain in the neck for you,” he said, “but the kids need a healthy grandma, and your friends can’t wait until you’re back on your feet and ready to get going again. Why don’t you do the at-home infusions, and we can find a way to work you social calendar around them?“ Deon consulted with some of his mother’s friends, and they happily arranged a schedule of ‘infusion dates’ so that there was someone around to talk, play cards, or have tea with his mom while she put up with the temporary inconvenience.