The Adult Version of “The Talk.”

On a cold January afternoon, in 2002, I took my grandma to lunch and visit her cousin. When we got back to her house she wanted to show me a few things, so our visit ended with her showing me where she kept her important papers, in the process she reminded me I was her power of attorney and told me her wishes if anything were to happen to her.  It seemed like a melancholy end to our visit, but I dutifully listened and noted her instructions, filing the information away for some later date.  Two days later my dad called to tell me she was in the hospital, where she had been since the evening of our visit, and she didn’t remember how she got there. The remainder of her life was very brief, but that 20 minute conversation saved me untold stress by clearing uncertainty about handling her affairs and ensuring I carried out her last wishes.

Her desire to communicate this information to me is not unique; in fact 82% of participants in one survey said it was important for them to put their wishes in writing, but a very small number, 23%, actually had at the time of polling(1). There are many reasons to avoid taking this step, time, awkwardness, procrastination, and reflecting on mortality are probably all reasons people would cite as excuses to account for the near 60% discrepancy between what individuals feel they should do regarding end-of-life decisions and actually doing it.

My own experience and volunteering for Hosparus, over the last two years, has given me insight into how important it is for families to have their final affairs in order for both emotional and financial wellbeing. One new training program Hosparus is offering volunteers to understand the challenges end-of-life present is the Conversation Project. This interactive workshop, also available to the public, was an engaging and very personal way to talk about our own thoughts regarding end-of-life concerns and actions we could take to ensure those wishes are honored.

The Conversation Project was initiated by Ellen Goodman in 2010 when she sat down with a group of colleagues, media and medical professionals to discuss what constituted a “good or bad death.”  The meeting resulted in a partnership with the Institute for Health to create an organization with the goal of making “it easier to initiate conversations about dying, and to encourage people to talk now and as often as necessary so that their wishes are known when the time comes (2).” The project has now grown to receive national media attention and has expanded to include both public and private options to engage the work.

The conversation I participated in through Hosparus was conducted in a formal setting by a trained facilitator who guided us through a series of exercises to gauge how we would want to be treated medically if we were terminally ill, the role our family would play in the experience, how our ideal final days might look, and how we would want our families to move forward following our death.  The Hosparus event, although intimate, was an eye opening experience to observe both the commonalities and unique wishes of the participants regarding their end-of-life care.  At the conclusion of the presentation we were presented with a template of “the conversation” available through their website (here) to take home to complete with our loved ones.

The Conversation Project is not a legally binding document or something meant to be a onetime event, but one designed to guide participants to legal guidance- such as a power of attorney or living will- and evolve as the people involved grow and change.  At the end of the Hosparus presentation we were also presented with an origami crane, to set in plain sight at home to remind us of our commitment to have the conversation with our loved ones.

If you are among the almost 80% who haven’t put your end of life wishes in writing I would encourage you to look into the Conversation Project. My origami crane is still sitting on my kitchen table encouraging me to have the conversation with my loved one, I agree with Dave Ramsey when he jokes in his “Financial Peace” program that talking about end or late-life care with our love ones is like having “the talk” when we are teenagers, it’s uncomfortable but necessary. I am grateful my grandmother had the foresight to have a conversation with me, it allowed me to make decisions about her health care that I knew were congruent with her wishes and was able to settle her affairs in a timely way that otherwise might not have been possible.  If you would like more information about a facilitated talk like the one I attended with Hosparus or if you have questions about their services you can call 502-456-6200 or if you have any questions about my experience with the Conversation Project please email me at; tune in next month for an article on the AMTA’s most recently adopted position statement, the effectiveness of massage on anxiety.

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