The Conversation I Hated to Have
The Conversation I Hated to Have
There was one conversation I hated, just absolutely hated to have with my dad when I was growing up. Can you guess which conversation?
It’s wasn’t about cleaning my room, my skirt being too short, getting my hair out of my eyes, standing up straight, doing homework, getting off the phone, or coming home on time from dates.
Nope. Not any of those, nor any that most people would probably think of.
It was the THE conversation.
The conversation no one wants to have. The conversation people think is so important, but they don’t get around to having. The conversation about end of life.
90% of people say that talking with their loved ones about end-of-life care is important
27% actually have done it
82% of people say it’s important to put their wishes in writing
23% have actually done it
80% of people say that if they were seriously ill, they would talk to their doctor about end-of-life care
7% report that they’ve actually done it
My dad was definitely an outlier, one of the 27%, the 23%, and the 7%.
As he transitioned from middle age into his senior years, he wanted to make sure that his family was prepared and that he got what he wanted. What did he do?
He talked to his loved ones.
He put his wishes in writing.
He talked to his doctor.
And he was prepared, as was everyone else. I still hated having the conversation because I didn’t want to face losing him. But he served as a wonderful model that’s made a lot of other difficult decisions in life easier because I saw how he did it. With grace and courage.
Needed Now, More than Ever
There are now more Americans age 65 and older than at any other time in US history. The population of people age 65 older had increased in just 10 years, from 2000 to 2010 from 35 million to over 40 million, a 15.1 percent increase.
Carrie Werner, a Census Bureau statistician comments, “The population age 65 and older has increased notably over time…It is expected to increase more rapidly over the next decade as more baby boomers start to turn 65 in 2011.”
If we truly want to honor how we lived, then let’s honor how we part.
Have THE Conversation
The Conversation Project is dedicated to helping people have the critical conversation that can make a big difference in everyone’s lives, those who pass on, and those who remain. The Conversation Project asserts:
“Too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain.”
“It’s time to transform our culture so we shift from not talking about dying to talking about it. It’s time to share the way we want to live at the end of our lives. And it’s time to communicate about the kind of care we want and don’t want for ourselves.”
“We believe that the place for this to begin is at the kitchen table—not in the intensive care unit—with the people we love, before it’s too late.”
What Are Some Models?
The best way to get your plan started is to get past your resistance and initiate your own “Conversation” with the people you love before it is too late.
One of the main sticking points is that many people want to address these issues but unsure where to start.
Groups, such as Engage With Grace, do a great job of helping to suggest questions that can start your own discussion. Here’s their “one slide” project to help spur your own conversation:
Can you and your loved ones answer these questions?
Atul Gawande, MD, author of several bestsellers, including, Being Mortal, has his own list of questions that we might want to address prior to facing a disease or end of life crisis. His list of questions is:
What is your understanding of where you are and of your illness?
What are your fears and worries about the future?
What are your goals and priorities?
What outcomes are unacceptable to you? What are you willing to sacrifice and not?
and later, What would a good day look like
Sometimes, time really is of the essence, and the things we want most are not always tied directly to the quality of our care or the extension of our life itself. Our priorities might have more to do with spending quality time with our family or friends.
Dr. Gawande tells the story of a woman dying of a fatal disease who, after being asked these five questions, revealed that she wanted to take her grandchildren to Disney World. Unfortunately, because the discussion happened too late, she died a few days later.
But things really do not have to end like this, planning can make a real difference.
Wellness Coaches: Helping with “The Conversation”
What nobody wants is to end up having to make end-of-life decisions on the fly. But, unfortunately, that is what over 50% of people in this country end up doing.
Often, when we fail to plan and face disease or catastrophic accidents, we might also end up not being where we want to be at the end or being treated medically in the ways that we might hope for.
This is where wellness coaches can help.
At the very heart of wellness coaching is caring and empathy.
Wellness coaches help people find the answers inside themselves and the solutions that work best for them. They particularly stress the importance of autonomy and choice.
This is why wellness coaches are particularly well situated to help people have “The Conversation.”
Wellness coaches can help people:
Realize that the discussion and planning does not have to wait until someone is confronted by harsh medical realities or faces a life-or-death situation.Wellness coaches can help people find their own ways to consider these critical issues and help them find ways to address them using methods that work and fit for them.
Understand that their medical providers can’t provide the answers for such personal decisions, and can’t be optimally effective with their help if it’s asked for only at times of crises.Help should come far earlier in the process of living so that people are ready to make the most of living (regardless of overall health or illness). Trained professionals, including wellness coaches, can help people define their goals and achieve them, with openness and support.
Use effective methods to explore their feelings and thoughts…and then take action by doing things that work to get them what they want and fit their interests, needs, values, and desires. Wellness coaches do it by active listening, insightful questioning and guiding, demonstrating empathy and open acceptance.
Dying How You Lived
A relatively small amount of planning can go a long way when it comes to end-of-life issues. And the stakes are high, we all would like our lives to end in ways that are the most comfortable and most in tune with our hopes and values.
Sheila Kitzinger, a champion of women’s rights in childbirth and pioneering feminist , approached her end in the same way as she helped other women in the birth process: clear-eyed and visionary. Kitzinger made a very elaborate plan for facing her death or the prospect of critical care that can be a model for us all.
She made clear to her family and her physician what her values were in terms of choice and control.
She appointed her sister power-of-attorney in the case she was incapacitated.
She made clear her desire to be allowed to pass away in her home instead of in a hospital.
She wrote an advanced set of decisions that covered how she wanted to be treated in the case she was faced with a situation she could not recover from.
This planning ahead allowed Sheila to set up a support system that allowed her to “die as she had lived, on her own terms.”
She passed at home, with the people she cared about without excessive medicalization.
By applying the values of autonomy and choice that she had championed for women in childbirth to her own death plan, she was not forced to spend the end of her life alienated from her principles.
Valerie Butler, lived an amazing and full life, but also made a plan for her passing instead of leaving all of her end-of-life decisions to chance. So, when she faced death, she also passed in her own bed, with family and friends near.
And as her daughter shared, while her death might have had messiness (as deaths often do), “she died the death she chose, not the death anyone else had in mind.”
There is a great deal of beauty and power in the way she passed, and that beauty and power started with having the important conversations and making a plan in advance.
The Conversation
If you are a wellness coach, you can make a real difference, helping people start their own “Conversations.” Considering the end of life can be uncomfortable to contemplate at best, but, can make a world of difference as people transition to end-of life.
At stake for all of us is having the ability to die on our own terms, with full autonomy, grace, dignity, and choice.
Have you started your “Conversation?” Are you facing any of the issues raised in this blog? We would love to hear from you, please feel free to leave a comment!
