A how-to guide to have the most important conversation of your life

Photo: Corbis

Photo: Corbis

Even in this age of hyper-communication, where people are willingly sharing all kinds of things with each other on social networks, there is one area of our lives where we quiet down completely. On the one hand, it’s not surprising. The topic is uncomfortable and the potential for misunderstanding is large. On the other hand, it’s shocking, because this is one of the areas that almost everyone agrees that more conversation is absolutely necessary. The topic is end of life care.

If we honestly assess ourselves, I’m guessing your reaction to the topic was to immediately think about other ways to spend the next few minutes. But hang in there, stay with me: I’m going to give you the tools to make this as easy as discussing any other important issue.

First, some context. If you haven’t yet had to deal with a serious illness– yours or someone you love– it may be hard to understand why this issue is so important. If you have, then you’re likely among the 60% of people who think it’s “extremely important” that their family members aren’t burdened by tough decisions (yet 60% have not communicated their end of life wishes.) Or consider this: 80% of people say that if seriously ill, they would want to talk to their doctor about end-of-life care, but only 7% report having had an end-of-life conversation with their doctor. Finally, 82% of people say it’s important to put their wishes in writing, yet only 23% have done it. In other words, you too have probably avoided this tough issue and you’re definitely not alone.

Most people, it seems, have trouble knowing where to start. We’re concerned that our loved ones won’t agree or even understand how we could feel a certain way. The key, says Ellen Goodman, co-Founder of The Conversation Project, is simply talking about it. And the best place to begin is at your kitchen table– not an intensive care unit– with people you love, before it’s too late.

Why is this important?

Imagine, for a moment, being seriously injured or ill, unable to speak for yourself, or facing the end of your life. Who do you want standing at your bedside, speaking for you, making tough decisions about your care– perhaps even disagreeing with other family members or medical professionals about how you should be treated? Now that you have that person in mind, do they know how you feel? Do they know what’s important to you, how you want to be treated?

Or maybe you’re in a position to make these decisions for someone else… do you know their wishes?

In either case, The Conversation Project believes that the key is communication. They’ve put together a ‘starter kit’ with a list of questions to first ask yourself to be sure that you understand your own feelings on the issue. The starter kit is available online and as a downloadable file. The questions are simple but thought-provoking.

Once you’ve completed the preparation, the next step can be the hardest: you have to talk with someone, tell them what you think, how you feel, and ensure that they are brave enough to adhere to your wishes in the midst of a challenging, emotionally-charged situation. Starting this conversation will be the most difficult step. It’s hard to bring these issues up (I’ve found that it’s tough writing about it, even in an abstract sense.) But having this conversation can be liberating for you both. It will give you the peace of mind that someone will be prepared to make your wishes known, and you will have the information you need to reciprocate. What could be better than having full confidence that you’re doing exactly what your loved one would prefer at that crucial juncture?

The starter kit is really the crux of The Conversation Project. This 10-page document will equip you to have this conversation with all of the important people in your life and will prepare each of you for the acceptance necessary to make it work. Following the conversation, the starter kit provides some valuable next steps: documents you should have on hand, further clarifying questions to deal with specific cases, and more.

If you’re still on the fence about whether this is important, consider one more item: 70% of people would prefer to die in their homes. The reality is the exact opposite: 70% die in a hospital, nursing home, or long-term care facility. Wherever you are on the spectrum, whatever your wishes for your own care, however you’d like to be treated, make your wishes known. The Conversation Project can help you do just that.

[Note: I realize this isn’t something that rises to the top of your mind when you think of things that need to be done, especially if you’re ranking them by magnitude of enjoyment. It’s tough; I get it. But it truly is important. If you still need convincing, spend a few minutes with Judy MacDonald Johnson as she tells her story.]

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