The Conversation

Having the Conversation

Ideally, conversations about death and dying start early in life and continue over time as the life cycle unfolds. In reality, this rarely happens. Most people remain uneasy with the subject of end-of-life care and admit they have no idea how to begin the conversation.

Opportunities surround us. For example, at a certain age people begin to scan obituary notices – “to be sure I’m not listed,” quipped one man. The illness or death of a family member or friend, or a news story or movie can lead to a conversation.

After attending the funeral of an uncle who had been unconscious and on life support for several months following a massive stroke, Selena turned to her husband, Danny and said, “I’d never want to live on a ventilator like Uncle Frank.” Danny nodded and thereby opened the way to other conversations that led to a discussion and documentation of their end-of-life wishes

A single sentence can provide guidance. When Kim and her husband completed their wills, she asked him, “Do you have any special requests?”

“Whatever is easiest for you,” he replied. When her husband died unexpectedly before providing further instructions, Kim felt uncomfortable making the arrangements she believed he would have wanted.

Talking about other people’s wishes may also spark a conversation. For example, “Dad, Aunt Pearl told me she wants cremation. Have you thought about what you would want?”

How to Talk with your Doctor

A white coat, unfamiliar medical terms, a hurried manner, and a beeping pager can rattle you enough to make you forget all your questions when you visit the doctor. What a physician actually says and what a patient or family member hears may be vastly different. When a husband asked his doctor, “How long do I have?” he later insisted the doctor said, “Two years.” His wife heard, “Two months.”

Write down questions in advance. Bring someone with you to take notes and provide another set of ears. If you don’t understand something or need to hear it repeated, say so. Make sure you understand what your diagnosis means and whether your doctor will support your choices. Well-intentioned, well-educated, and well-trained physicians will more often than not resort to aggressive treatments at the end of life unless you tell them otherwise. Good decisions about your care are not automatic; it’s up to you to make them happen.

Excerpted from The End-of-Life Advisor: Personal, Legal, and Medical Considerations for a Peaceful, Dignified Death ©