End-of-life talk not pleasant, but necessary

It’s time to talk. About something difficult, something so terrifying to many that it’s almost taboo.
The topic is end of life. That’s what The Conversation Project is about.
Pulitzer Prize-winning journalist Ellen Goodman began this effort in Boston several years ago. This year she will turn 76 herself, and knows personally that end-of-life issues must be discussed by everyone. Like all the more usual kinds of insurance, The Conversation is something to be had well in advance of need.
There’s a helpful little booklet, Your Conversation Starter Kit, with this tagline: “When it comes to end-of-life care, talking matters.” It’s a tool for action, a guide that pulls no punches. No one wants to confront these issues, which makes talking about them something to avoid. The booklet acknowledges, “Parents are reluctant to ‘worry’ their adult children; children are reluctant to bring up dying with their elderly parents. We like to say ‘It’s too soon,’ when we know it’s always too soon until it’s too late.”
The Conversation Project isn’t about wills, health care proxies or advance directives; ideally, these should be taken care of after the conversation, because they are legal documents that will come into play at the very end of life and after it. This project helps people define what goes immediately before.
I turn on my radio and hear a respected financial adviser speaking, but not about money. He is asking people to think about where they want to be when they have received a terminal diagnosis: At home? In hospice? Hospitalized? Whom do they want with them when finality approaches: As many family members as can come? A few nearest-and-dearest? Clergy? What will they want: Warmth? Hand-holding? Favorite music playing? Someone reading from beloved books? Prayers? Or just plain peace-and-quiet? I realize that he is speaking beyond his usual issues, advising listeners to think about the very kinds of questions that can be asked, and answered, during The Conversation.
Someone who has already been personally involved with this project has said that “some of the issues that are part of the conversation include sharing what’s most important to you, knowing who you want — or don’t want — to be involved in your care, and worrying that you won’t get enough care — or that you’ll get overly aggressive care. Participating in the project can alleviate the awkwardness and discomfort of sitting down with our loved ones to uncover desires regarding end-of-life decisions. One of the final acts of love is knowing and following the end-of-life wishes of those we hold dear. This isn’t an easy task…”
For all who are interested in easing the way toward having this most important conversation, Congregation Beth Torah has scheduled an initial meeting to explore preparation for it. Leading discussion on how to approach the many vital, even critical, issues will be Peggy Papert, a social worker well-known in Dallas for her 15-year directorship of Temple Emanu-El’s extensive Caring Congregation program. This first conversation about The conversation project will be held in a private home, beginning at 7 p.m. Thursday, Feb. 23. To RSVP and get specific location information, email inclusion@congregationbethtorah.org.
Laurie Miller, president of Apple Care and Companion in Dallas, is spearheading the effort locally. “This is not just for the person at the edge of death,” she says. “It is a road map to provide awareness for all of us.” Conversation starter kits are being distributed by the Dallas Area Gerontology Society (DAGS), a nonprofit voluntary organization.
The old saw says nothing is inevitable but death and taxes. Well, we’re in tax season now, and will be, again and again, every year for as long as we live. But we’ll die only once, and we don’t know when that one time will be. Having the conversation far in advance of need can help assure that end-of-life desires are clearly expressed and understood. And that they will be followed.

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