Dying is a universal experience. Nearly everyone has a story about a good death or a hard death among those they love. The difference between these experiences may rest on whether we have shared our wishes for how we want to spend our final days.
How we want to die is the most important and costly conversation Americans aren't having. Consider these facts:
- Ninety percent of people think it is important to talk about end-of-life wishes with their loved ones, but only 27 percent have done so, according to a 2021 study published in the Journal of Psychosocial Nursing and Mental Health Services.
- One in 5 respondents to a 2018 survey by the Conversation Project, which works to promote greater discussion of end-of-life-care, said they've avoided the subject out of worry about upsetting their loved ones.
- A sizable majority of people say they want to die at home, but 60 percent die in hospitals or institutions.
Planning your final days is never easy, but it's an invaluable gift to your loved ones. These discussions can be among the richest and most intimate that friends and family share. Studies show that when there is a meaningful conversation about end-of-life choices, survivors report feeling less guilt and less depression and having an easier process of grieving.
And thinking through these issues before a medical crisis — at the kitchen table rather than in the intensive care unit — will help you and your loved ones make decisions based on what you value most, without the influence of stress and fear.
Helping families do that is a key goal of the Conversation Project, which Pulitzer Prize-winning writer Ellen Goodman cofounded in 2010 after serving for many years as caregiver for her mother.
Here's a plan for getting started, drawn from Your Conversation Starter Kit, a downloadable guide developed by the Conversation Project to give people a jumping-off point for this all-important talk and to help them keep it going over time.
It's fine to spend some time thinking about the conversation before you dive in. As you prepare, ask yourself these questions:
- What do I need to think about or do before I feel ready to have the conversation?
- What particular concerns do I want to be sure to bring up? (Examples might be getting finances in order, or making sure a particular family member is taken care of.)
Consider having a practice conversation with a trusted friend, or writing a letter to a loved one (or even to yourself). And remember that the conversation might reveal disagreements. That's OK. You'll want to discuss those issues now, not during a medical crisis.