Have you recently received a negative diagnosis from your doctor? Or have you ever talked with your family about end-of-life issues? Have you and your family discussed quality of life versus quantity of life? How about a DNR, or life support, or feeding tubes, or home versus nursing facilities?

According to statistics, about 90% of people say it is important to talk with your family about end-of-life issues. However, only about 27% have actually raised the topic with their families.

Since most of us want to discuss these important issues, why don’t we?

The truth is, these conversations sometimes fill us with dread and worry. We all know that families are complicated, and perhaps we don’t know how they will react to topics such as these. Maybe we are waiting for the right time or the right occasion.

It is also true that no two families are exactly alike. The dynamics of your family are very different than those of my family, so I cannot tell you exactly how to have this conversation. However, I have found some helpful tips to get us talking.

These conversations are necessary, whether they concern a recent diagnosis, or we just want to be sure our family knows how we feel about end-of-life issues.

The time to talk about these things is now, while we can. One day we may become unable to speak, so let’s do this sooner, rather than later.

The Setting

We may hope to choose the setting, and while it may never be perfect, if there are ways we can control it, the conversation may be better received.

If our family can be comfortable and not feel threatened, that is always a positive thing. However, if the occasion is in a hospital room and I am the patient, then the time is now. Sometimes it just cannot wait.

Be Educated

If we must reveal a diagnosis, we can research the disease or condition so we can speak intelligently about it. An alternative is to have a healthcare professional present to answer questions about it.

If the topic is end-of-life issues, such as long-term care, organ donation, cremation versus burial, remaining in our own home versus assisted living or nursing home, we can also research these topics beforehand to be able to speak about them knowledgeably.

We can present our case to our family with confidence showing that we understand the options and have thought them through.

Have a Note-Taker

It will be important to have someone take notes about what is discussed and what, if anything, is decided.

Sometimes, after a lengthy discussion, we leave a meeting wondering what the results were. This is especially true if promises are made, or when family members agree to help in some way. We don’t want to trust our memory about these important matters.

Talk First, Then Listen

It is important that we state our case so that our family understands our feelings, our wishes, and our desires. It does take courage to speak up and share our thoughts about these serious topics, but they need to know our hearts.

We need to convey to our family what things are most important to us, especially speaking of quality of life. These may be very emotional conversations, so having notes with us might keep us on topic.

Following that, we owe it to them to listen to their opinions and to hear their thoughts on these matters. There could be aspects we have not considered, so we should hear their ideas.

Often, we feel our choices are either/or, when our loved ones might know of other options that we have not explored. Dialogue doesn’t mean we must disagree, and it doesn’t have to end in disaster.

One resource that is invaluable to discussing end-of-life issues is Hospice or similar organizations such as Vitas. Their websites have a wealth of information for those with chronic illnesses, and their healthcare professionals are a valuable resource.

Another intriguing resource I have recently discovered is The Conversation Project. This endeavor began for the express goal of making it easier for families to discuss end-of-life issues now, before it is too late. Here is a quote from their website and their founder:

“When loved ones are in good health, some people may feel it’s too soon to discuss end-of-life matters. Adult children don’t want their parents to think they are giving up on them. The older parent fears the subject of their death will unnecessarily upset their family. Others feel as if talking about dying will make it happen. As Pulitzer prize-winning writer and founder of The Conversation Project Ellen Goodman says, ‘It’s always too soon until it’s too late.’”

On their website, they offer resources for how to begin the conversation, topics to discuss, and how to end the conversation. I found their suggestions very helpful in speaking with my husband and my children about death and the surrounding topics, and how to do this in a natural way.

The truth is that we need to have these conversations as casually as possible and treat them as a part of life, while discussing death.

How have you approached to subject of end-of-life issues? I would love to hear your story about your family and how you discuss topics surrounding the end of life. If you haven’t done this yet, sooner is better than later!

Let's Have a Conversation!