sad elderly woman

Benjamin Franklin once wrote, “In this world, nothing can be said to be certain, except death and taxes.” While I can’t speak for taxes, death is inescapable. Yet despite death’s certainty, most Americans avoid talking about it. According to a 500-page report by the Institute of Medicine (IOM), less than 30% of Americans have had end-of-life discussions, though 90% believe these discussions are important. Consequently, when most of us finally decide to talk with a loved one about this inevitable life event, we are treading on new and potentially uncomfortable ground. Unfortunately as we tread lightly on this new topic, we often make mistakes that ultimately keep our loved ones from getting what they want and need in their final days. To avoid these pitfalls, here are five common errors and how to prevent them:

1. Starting too late

As most people near the end of their lives, they are not physically or mentally able to make their own decisions about their care. If family and doctors don’t have this conversation early on, when the time comes to provide care, it may be too late to ask the patient what she or he wants. The IOM report suggests having ‘milestone-specific’ conversations that can begin when you get a driver’s license or leave for college. The goal is to normalize conversations about death and help make them regular so that preparation can start earlier. Many organizations are trying to break the taboo on death by offering online tools to get the conversation started or by helping you plan an evening to discuss death over dinner. Ultimately the goal is to not let the discomfort of the subject keep you from acting and preparing.

2. Cutting off the conversation

Talking about death can be scary, so it may be tempting to cut off a loved one’s attempts to talk about it. Family may see talking about death as a loss of hope or lack of desire to keep going. Rather than shying away from the conversation or cutting it short by saying “It’s too early for that” or “There’s plenty of time to talk about that later,” when your loved one starts to talk about it, push aside your own discomfort and let them talk. It’s unlikely that your loved one will always feel comfortable talking about death, so take advantage of these moments to listen and to ensure you understand what they want.

3. Invalidating your loved one’s feelings

Don’t invalidate the emotions either you or your loved one has while talking about death. You can and should acknowledge how these emotions may be influencing your decisions and actions. Recognizing that fear may be driving choices can help involved parties make clearer decisions and start an unguarded conversation about what everyone is experiencing.

4. Not covering the options

If your loved one is open to talking about death, take the time to cover all the bases. Understand what your loved one wants in a wide variety of situations and not only the best-case scenario. Many doctors admit to suggesting treatments that they don’t believe will work, opting for being too optimistic over being too pessimistic. It’s important to know what your loved one will want when their health becomes dire or their judgment isn’t clear. Though most Americans say they would like to die at home, 75% die in a hospital or nursing home. Understanding what your loved ones want and in which cases they do not want intensive treatment can help them die with dignity and prepare early to make their wishes a reality.

5. Not taking note

While listening is the most important part of an end-of-life talk, it’s a good idea to take note of what your loved one is saying. Sometimes these conversations only happen once, and you’ll want to remember what was said. Take notes or make a recording of what your loved one says so you can refer to it later. Especially in relation to legal matters, your memory won’t be enough. Get things in writing whenever possible or have them drafted by a lawyer to guarantee that these wishes are respected.

 

Death doesn’t need to be a scary subject or a scary event. When you take the time to prepare for it, it can be a comfortable and even beautiful part of life. A conversation about how you want to die can be one of the most empowering conversations you have with a loved one. After all, as the philosopher Baruch Spinoza once said about contemplating death, the conversation is a “meditation not on death but on life.”