It seems that our dinner table is the place for all family levity and includes heavy discussions and lighthearted disagreements.  As we pass around the pasta, we begin pounding out our opinion about a medical study, a friend’s Facebook posting, the last family gathering, and a potpourri of other topics.   I can’t help but think about The Conversation Project, and how the discussions about end of life wishes should start at the dinner table.  Yes, I have had the discussions and heard, “Oh, Mom” more than once.  My children, though adults, seem to think death is a long way off.

Maybe.  Maybe not.

That is the whole point in discussing NOW what I want my end of life to look like.  If a time comes and I can’t remind them, they can at least know what I wanted from discussions had long before they stand around my bed in an ICU.  I hope that won’t happen.  But it is an all-too- frequent scenario, happening in every hospital across the country.

I read a recent study that reported more people are dying on hospice services, (though for fewer days); There is also a higher percentage of people spending time in the ICU the last month of their life.  I can’t help but wonder; When is that first conversation about what a person’s end of life wishes happening?  When the palliative care doctor meets with the family members while the patient lies in a hospital bed, non-responsive on the mechanical ventilator in the ICU?  So maybe that person gets to go home on hospice, for a few days, before they die.  Is that really how they pictured their last days and weeks of life?

This is why I talk about it now: to avoid such a scene.  For Helen, it didn’t happen too differently than the above scenario.  At least she was able to say “I want to go home”, and her family could honor that wish.  But only after countless days of tests, intravenous medications, restless nights on a ventilator before she awoke enough to say “No more”, following too many days of unnecessary suffering.  She died only a few days later, at home with hospice care, and so thankful she had been able to have any conversation about her wishes.  I was sorry for her that the dinner table didn’t include THE TALK long before debility and illness caught her off guard.

I read recently about another phenomenon, people having dinner parties and death being the topic of conversation (perhaps this was inspired by the “death cafes” started in Europe where people drink coffee and tea and eat snacks and talk about death).   Quoted from the article, “There is power in speaking about something.”

But for so many, we would rather talk about ANYTHING else, I think. ” Everyone nods their head, yes it is a good thing to do, but talk must be turned into action. (And for every person who expresses their wishes for end of life care, these need to be put in an official document, that’s the next step!)  Not just wishing on a star and hoping it comes true.  Begin now, and have the conversation.