How to begin a conversation about end of life planning

Over the past ten years a small team of us have had the honor of sitting with thousands of people to discuss their mortality, fear of death, and the challenges inherent in talking about end of life planning. We have learned many things, and are still humbled by what a difficult conversation this can be. Here are some of the universal lessons we have learned.

Start by starting.

This is true for writing a book, completing your taxes or shedding a couple pounds. It is also the most important lesson we can share about having a conversation about end of life care. To talk about this topic you have to start somewhere, and you might have to keep starting. It’s hard to hear but I strongly believe the we ourselves are the biggest obstacle to having this conversation. If the topic of wills and advance care directives and funerals makes you uncomfortable, the friend sitting across from you will feel your anxiety, and that is ok. Our suggestion is to own it, acknowledge that it makes you uncomfortable and give it a go anyway.

If the person you want to talk to is your spouse, parent, child or even a friend - there is a good chance you will meet some kind of resistance when you embark down this conversational road. Our suggestion is to get ok with a little rejection, don’t take no as a final no, and get really good at starting the conversation.

Don’t make it “the” conversation

No one wants to have “the” conversation about... well, anything. Be that drugs, sex, money, or even feelings. If we put too much pressure on a single conversation it will almost always reduce the likelihood of vulnerability and connection. We are human, which means we die, and just like the other undeniably human things, we should have many many conversations about end of life. Set yourself up for success by thinking of the end of life conversation as a whole bunch of mini conversations, some will be the length of a tweet, others will be a beautiful long walk in the woods.

Talk about you.

The worst place to begin is the word: should. I don’t like anyone telling me I should do this, or I must do that, unless it is a binge worthy Netflix series. I would suggest that you begin every conversation with a story about yourself, a feeling you are having, a fear you are experiencing. For example: how good it felt to get your will complete and how long you put it off because it gave you anxiety to even consider it. The secret sauce is to be vulnerable yourself, vulnerability is contagious, so take a risk and say something you are afraid to say.

The goal is listening

So often when we have a conversation about these topics we have a goal in mind, a direction we want it to go, an action we want someone to complete. The real goal here is to create a safe space for listening. You want to be the person who they feel comfortable talking to about funerals and what great end of life care might look like. The goal is not to have the paperwork complete, that is quite frankly easier than cultivating a safe place for listening. If you get someone talking and sharing you are most of the way there.

Know your audience

I think about the many conversations about end of life as a kind of non-romantic courtship, which always includes knowing your audience. You don’t bring someone a beehive if they are allergic to bees. Similarly, you need to know your friend or loved ones interests. Is it music? If they are an Aretha Franklin or Prince fan you can definitely talk about how hard it has been for their loved ones because neither of these great musicians left an actionable will. Do they love trees and nature? Then you have a perfect opening to talk about green burial and the remarkable work of Recompose or the Green Burial Society. Their interests and passions are the clear path into this conversation.

Let’s call this part one of our learnings, there have been so many, each situation is a bit unique and we are here to help you navigate all of these difficult roads. Join us each week as we continue this conversation with Dr. Jim deMaine - for Ask The Doctor every Tuesday at 11am PT. 

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