“The Conversation” … How to initiate it? How to sell the reader on the importance of it? As I replay these questions repeatedly in my mind, I reach for pop culture iconography for parallels and yes, please, for levity. Why does the catch phrase “The Contest” keep interrupting my thought process? “The Contest” was the hilarious Seinfeld episode that stoked the embers of water-cooler banter for weeks. Oh, how I wish “The Conversation” could somehow play out the same way. “Hey, tonight I am having the conversation? Oh, I hear Bob had the conversation …”

The conversation I am referring to is about end-of-life care for our aging loved ones. In reality, it is the birds and the bees for our parents. Replacing “how babies are made” with “end of life decisions conveyed.” Both conversations, awkward, necessary and, if left unspoken, are potentially emotionally and/or physically damaging. “The Conversation” is really a misnomer; ideally we should be having several conversations with many facets of end-of-life care to discuss. The biggest obstacle is overcoming the dread and getting started.

The reality is that no one wants to consider his or her own mortality. Billy Crystal says it best in his book, “Still Foolin’ ’Em”: “And you know how in the back of your mind you’re thinking that you’re going to be the one that gets away with it, that you’re going to be the one that G-d, like a bouncer at a nightclub, lets slip by? It doesn’t work that way. For anyone. In fact, you know who else thought they might slip by? Every single person now in the cemetery.”

Initiating “The Conversation” is a gift of love that families give to each other. The trauma and conflict of not knowing your loved ones’ wishes can tear families apart. Doesn’t it make sense to communicate, understand and memorialize your wishes on how to navigate and proceed with decisions that present at end of life? Siblings and close family members should be hugging and comforting each other during this time, not bickering and second-guessing themselves and each other. It is a fact, avoiding “The Conversation” leaves survivors feeling guilty, depressed and uncertain. 

Consider these facts:

• 90 percent of people say that talking with their loved ones about end-of-life care is important, but only 27 percent have actually done so. (Source: The Conversation Project National Survey 2013)

• 60 percent of people say that making sure their family is not burdened by tough decisions is extremely important, but 56 percent have not communicated their end-of-life wishes. (Source: Centers for Disease Control 2005)

• 80 percent of people say that if seriously ill, they would want to talk to their doctor about end-of-life care, but 7 percent reported having had an end-of-life conversation with their doctor. (Source: Survey of Californians by the California Healthcare Foundation 2012)

• 82 percent of people say it’s important to put their wishes in writing, but 23 percent have actually done it. (Source: Survey of Californians by the California Healthcare Foundation)

If I may run with my Seinfeld analogy, “The Contest” took a subject, taboo for casual conversation, and put it out there for all to acknowledge, no matter how awkwardly. The brilliance of “The Contest” is the figurative dance around the subject matter. Well, at the risk of being called a wallflower, I’m not dancing. I’m here to tell you dying is not optional. It is in G-d’s hands, but how we live up until that moment is in our hands, and that is what we need to talk about, no matter how uncomfortable it makes us. 

We must empower our aging parents and assist them to gain control of the end of their life, in the same way they controlled the prime of their life, and in the same way that they have guided their children to handle life’s tough decisions.

“The Conversation” should be ongoing conversation. We would like to make sure that you include your professionals (attorneys, CPA’s, financial advisers) as well as your doctors in this dialog.  

By having “The Conversation,” families unite to uphold the legacy that our parents worked so hard to nurture. Stay tuned, we are sure to have more dialogue on “The Conversation” in future columns.

Bob Roth is managing partner of Cypress HomeCare Solutions, LLC. For more information, visit cypresshomecare.com.


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