Imagine your best friend tells you they’re going to have “the conversation” with their spouse. What do you think? It’s the conversation about retiring? They want a divorce? A new car? Whatever pops first to mind likely represents both your understanding of your friend and the recent stressors in the relationship. Because “the conversation” implies a heavy subject fraught with emotion. It also implies a subject difficult to broach.
Having “the conversation” about end of life
The Conversation Project is therefore aptly named. 90% of people say talking about end of life care with their loved ones is important. But only 27% of people have actually done so. The Conversation Project is dedicated to helping people have the never-quite-the-right-moment conversations around end of life issues. The website offers a “starter kit,” a downloadable PDF of information that helps you get your own thoughts together and gives advice about how to bring up your wishes with those you love. There are no right or wrong answers about your own feelings and wishes. You may want all possible measures taken to prolong your life, you may want few, or somewhere in between. You may not think you have enough information to make an informed choice, or you may never have thought seriously about what your own priorities are. The starter kit provides a set of questions to help you think of your own answers. It’s a template, and in addition to the adult version, there’s a pediatric version for parents of seriously ill children and one for having the conversation with your doctor. It’s also available in Spanish.
There are other resources as well. The Consider the Conversation set of 2 award-winning documentaries bring to the screen the struggles around talking about and preparing for end of life. The Institute for Healthcare Improvement offers an audio broadcast about how to spread these conversations in communities. La Crosse, Wisconsin doesn’t need much help, because the conversation started there on a large scale a while ago, greatly through the Respecting Choices model of advance care planning. And Minnesota may have embraced the community process to a greater degree than any other state: see Honoring Choices. There are also many books on the subject, the newest of which is Atul Gawande’s Being Mortal.
Misinformation, distrust, and hidden agendas swirl together in Francis Ford Coppola’s 1974 film “The Conversation.” Conversations around end of life preferences need not be so dramatic. We can have them over the dinner table, snuggled up on the sofa, and while taking a walk. They don’t have to be one get-it-out-now-or-never monologue. They can be evolving dialogues with questions and answers, breathers, silence, and more talk. They are what you make them. The important thing is to make the time to have them.