In response to my 8/9/10 post entitled “The Importance of End of Life Preparation,” Valencie Bathe wrote:

How I want to die needs to be dinner table conversation… not whispered and forgotten. There is no shame in dying and planning to die only makes sense. But owing to undue medical and legal intervention in America, we “fight it off” and end up, sadly, in ICUs being subjected to the horrors of healthcare. Until we grow up as a society and recognize that life ends, we won’t plan for it and we’ll continue our heroic measures (at untenable costs both to society and to loved ones). As a Hospice volunteer and patient advocate with a right to die organization, I find that my friends and family gradually develop the ability to discuss death and dying with me (when at first they put their hands over their ears and sang “La La La La” to keep from hearing it). It gets easier with practice. Talk about dying, plan for it. It makes life much easier and relieves underlying fears.

Here are several suggestions for how to have this very important conversation with those you love.

1. Talk to yourself first. No matter how uncomfortable you are with the reality of death, make a commitment to yourself to face your fears. Desensitize yourself to your fears – look at them one by one and choose to move past them. For some, this takes more courage than for others. If you find you are unable to make progress with this, consider seeking help from clergy, family, friends, or a counselor. Like entering the ocean, some of us dive in head first while others take forever adjusting to the rising level of the water against our body. Don’t allow yourself to abandon the process just because it is hard for you. Know that the liberation you will achieve will be well worth any discomfort you go through.

2. Figure out what you think and feel about death and dying. Ask yourself some deep questions about your beliefs and values like the ones presented in last week’s blog. Then take the next step of figuring out how that translates in general terms into your own end of life care, the disposition of your body, what kind of end of life ritual would be right for you and what is important to you about how your personal possessions and wealth are distributed after your death.

3. Trust your own judgment about whether to legalize your wishes before or after talking with your loved ones. Some of us are painfully private people and really don’t want to talk about and explore beliefs about death and dying with other people. That’s just fine. However, your loved ones may have different needs and it is important to find a way to support each other. If you can’t talk about it — at a minimum document your personal preferences.

4. Don’t wait until you are dying to talk about death and dying. Invite conversation on this topic with the goal of making it more normal to talk about such things.

5. Create an emotionally safe space for exploring and sharing thoughts about death with your loved ones. This is not about convincing one another that you have a superior point of view. Rather, it is essential that we learn to deeply honor each other’s right to have a different point of view – not better or worse than ours, simply different. Cultivate a spaciousness in your mind that invites dialogue. Otherwise, others will clam up around you and you will never really know what matters to them. Demonstrate your love by bearing witness to their truth. Seek to really hear each other and to respect one another’s right to their own personal truth. When adult loved ones talk to each other about death it can be especially hard if they have spent many years being silenced by our society’s taboo against the subject. It can be awkward and disturbing for some. Someone needs to be brave and set the right tone.

Parents of young children can do a great service by teaching them about death as a normal part of life. (See my 6/28/10 post:12 Ways to Help Children Understand Death.) Each family’s circumstances and situation is different, and it is up to parents to be sensitive in choosing an appropriate time to broach the subject. Ideally, this is done in the normal everyday course of life rather than within the context of grieving. I am a big fan of regular family meetings to provide a forum for families to build their connections to one another – to clear the air when necessary and to discuss matters that affect their mutual well-being.

6. Take it one step at a time and be honest with yourself and your loved ones. If you are scared, say so. That’s perfectly fine and natural. Just allow yourselves to be honest about your present state with regards to death and start there. You might want to try the following steps, knowing that the process may well take several conversations:


    • Begin by talking philosophically and conceptually about death. Discuss your thoughts and feelings about the facts and observations presented in my post last week as a conversation starter.
    • Take the time for private contemplation to explore your personal thoughts and experiences regarding death. Use the questions I posed last week or develop your own list together.
    • Share your thoughts and experiences with each other. This will provide a foundational understanding of your personal preferences regarding your own end of life.
    • Share your personal preferences with each other.
    • Make a shared commitment with a deadline to finalize or update your end of life legal documents and to provide a copy of your healthcare proxy and living will to your doctors.
    • Acknowledge yourselves for your mutual completion – have a party!

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