Some say the best way to avoid a difficult conversation (like end-of-life care planning) is to ignore it until it goes away (my mother was brilliant at this strategy). My personal experience has taught me that if we ignore the end-of-life conversation long enough, it will indeed go away, and with little help from us. After a lifetime of observation, I feel fairly confident in saying that many of us expend a great deal of energy trying to avoid the topic of death, and the preparation required for the final act of our lives. It’s not an easy conversation for most of us to have, not even for those of us who work, study and write about it. We occupy our minds with everything but that which needs to come to us more naturally, more easily. We push hard conversations and challenging thoughts to the remotest corners of our minds, then quickly rush out the door and lock it away from our consciousness.
But end-of-life challenges always come knocking on locked doors, even if we trash the key. Both of my parents struggled to talk about end-of-life issues, particularly my father. Death and dying were things that happened to other people, not our family, and the thought of preparing for the eventuality of death signaled defeat. It took many trips and conversations with my father before he would finalize his advanced care directives. He had always been very uneasy with the idea of dying because he knew it was not something he could control (I should add that I seldom drove the car when Dad was in it, because he was not in control). But the one thing my father did know, and was quite successful at achieving, was dying in his own home with the support of Hospice, with his family by his side. If he had to go, by golly, it was going to be in an environment he loved and was familiar with. He left rehab after a severe illness with the rehab team to decide what would be needed in the home for support once his rehab was finished. He sat down in his favorite chair and refused to go back to rehab. He never left his home again after his personal “sit-down”. He had grown accustomed to the difficult conversations and had finally made up his mind – the final and most important act of power he had left in his rapidly weakening body. I applaud my father for knowing, when the time came, exactly where he wanted to be when it was his turn to go.
May we all fear less the difficult conversations.