That distressing but unavoidable conversation

I recently sat in a small circle of people in someone’s living room, learning how to have The Conversation. Capitalized, because it’s such an important conversation, one most of us don’t even want to think about it, let alone have. It’s the advance talk about what we, and our loved ones, want for the very last of our lives.
Yes, it’s open talk about dying. But the emphasis is on making life’s end — the inevitable for all of us — the way we choose. So first, we must be honest about accepting that inevitability, and then we can go about having The Conversation.
Some people are unlucky enough not to have any end-of-life choices. They’re killed in a random drive-by shooting. They’re hit on the head by something heavy falling from the top of a tall building when they just happen to be passing by. Or they’re marched away by a Hitler henchman, as so many of our people were in a past time we don’t dare forget. But for us who are living, and thinking about living but aging family members, having The Conversation should be at the top of the to-do list.
In the quiet room where I so recently sat, Laurie Miller led us through The Conversation’s steps. She knows how to do it, because for over a decade she’s been caring for the sick and the elderly in our community, and now she’s working with the Senior Source, the Dallas Area Gerontology Society, and other service groups to get the word — and the words needed! — out to many others.
Everybody is going to die, regardless of anything else. It’s interesting, I think, that it’s Jews who are leading this effort to make personal choices for end-of-life living: This project was the brainstorm of Pulitzer Prize-winning Ellen Goodman, the Boston columnist who first articulated the need for The Conversation as her own parents aged. And Laurie Miller proudly announces her local temple membership along with the work of her company, Apple Care and Companion.
We didn’t have The Conversation itself in our little group; we spent a couple of hours of learning when and how to broach the subject, and what should be talked about. Everybody got a Conversation Starter Kit outlining a Ready-Set-Go method of approaching those we should be talking with, a gentle path from thinking about matters that nobody really wants to talk about to acknowledging the reality that we must confront them. Because if we don’t, our final decisions are likely to be made by dispassionate strangers.
The Conversation itself will include such simple things as a preference for where to die: at home, or in a hospital or other care facility? Personal comfort: sheets tucked around the feet or not? Pain: ask for medication, or let others make that decision? Company: someone to hold your hand? (And who should that someone be? Or would you rather be left alone?)
Music? Words being read aloud? (It’s widely believed that the sense of hearing persists almost to the very end of life, so what — if anything —would you like to hear?) Would you or your loved ones choose to have a rabbi or other clergy person — remember, this is a non-religious project, open to all — pray with you? These decisions should all be made in advance of need, in addition to estate plans and wills for taking care of post-death financial matters.
The Conversation Project also puts emphasis on the people who will make our end-of-life medical decisions when we can’t do so for ourselves. In addition to the Starter Kit, it provides an invaluable second booklet on both choosing a health care proxy and on being one ourselves.
In our little group, some people cried. Many asked questions. Everyone said thank you at the end, and meant it. I’m hoping many more will soon prepare to have The Conversation. The Conversation Project, now a recognized nonprofit, is ready to help.

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