How to have THE CONVERSATION

With the holidays fast approaching and families gathering, here’s a great opportunity to let your loved ones know what your wishes are with regard to end-of-life issues.

It’s a delicate subject to raise, of course. Our culture is not very good at preparing us to talk about such a taboo subject. Our loved ones might have objections such as “Really? NOW?” or “Can’t we talk about something more pleasant?” but the reality is, having clarity about what we all want at the end of our lives benefits everyone. This clarity does need to be communicated, though, or it’s useless.

First, are you clear yourself about what you want? Do you have an advance care directive in place—where your loved ones can find it easily, as well as your medical provider? (The balancing act between being comfortable vs. lucidity vs. realistic treatment options must be thought through carefully. A medical professional, death doula, social worker or clergy can help talk through the issues with you if necessary.)

If you’re clear and comfortable with your decisions, one way to approach the topic is by using the case of a family member and saying — “I’d like that for me” or “I really don’t want to put you all through that.” Some people find it helpful to turn it into a game — laughter can help with the awkwardness. (See one possible example here.) Another possibility is to give everyone a sheet of paper to draw how they’d like to spend their last few days — or, even more important, how they WOULDN’T like to spend them.)

Most North Americans say they want to die at home, but the vast majority die in hospital. Having clarity about your wishes and conveying them to your loved ones definitely increases the chances of their being followed. Don’t wait until it’s too late, a scenario which is sadly all too common, and can lead to strife between loved ones. It’s a gift to your loved ones to be able to take the burden of hard decisions off their shoulders; they have enough to be dealing with already!

Let's talk...

Would you be open to a conversation about your current health, your love of life/living, and planning for your death? Maybe two out of three? I have observed in “American” culture (an overly broad category including a great diversity of cultures, races, ethnicities, generations, and genders), and experienced personally, that people shy away from these conversations.

In contrast, I find that having open, exploratory, and deep discussions about ideas, questions, and wishes for the end of our lives often leads to a greater appreciation of every moment we are alive and an increased sense of peace about our final days. It is ideal to have these conversations, over time, with those closest to us (family members, a best friend, or an inner circle of friends). Often, that is a challenging place to begin. Is that surprising to you?

Last year, in my role as a chaplain in a hospital setting, I was uniquely placed to talk with patients about the challenges they were facing with their health and to imagine their futures. We talked about the changes in their lives, the quality of their lives, their relationships, fears and hopes, and how they wanted their lives to be at the end. These were special times. It would be my wish that we all had these conversations in our close relationships.

With whom, and how, do you wish to spend your final days? What are the directions you will give to your family members or close friends so that your wishes about how you will live/what measures will be taken to keep you alive and how you desire to die?

Everyone I speak with and record for (graphically recording their end-of-life wishes) wants to be at home surrounded by family. Happily, there has been a decrease in the number of Americans dying in hospitals and an increase in people dying at home and in hospice. Regardless of where we die, if we want the ends of our lives to be in alignment with our values and wishes, we must plan for it. We need to find a way into conversations with those who may be involved in the process.

If you are looking for resources available for planning your someday death, we (www.veoli.net) have information that can help you begin the journey. Please reach out to me so that I can help you take a step on the path to planning and to enjoying even more fully every day of your life.

Just in case you would like to learn more about what a chaplain does, here is a link to the zine I created for patients and families. If this can be of use to you, please reach out to me (jill@jillgreenbaum.com) and I will send a paper copy.

Australians are Dying to Know

I have been very impressed by the Groundwell Project’s Dying to Know Day, which celebrates its tenth anniversary this year. The initiative seeks to get Australians to think about their end-of-life choices and then communicate them to their loved ones.

I wish there were other such initiatives in the northern hemisphere! Maybe September isn’t a bad month to choose.

Have you thought about your end-of-life choices? Do you need help visualizing them as a way to help you communicate your wishes to loved ones? VEOLI can help; let us know if you need a hand!