By Rosemary Lloyd
CAMBRIDGE, Mass. (JTA) — Talking about death makes some people uncomfortable. Of course, we think we should talk about it. Ninety percent of Americans surveyed said it’s really important that we talk with our loved ones about our wishes for the kind of care we would like at end of life. Yet fewer than 30 percent of us have actually had these conversations.
There remains a yawning gap at the end of life between what we hope for ourselves and our loved ones, and the reality of what is happening.
What’s the gap? Well, 70 percent of us hope for the deathbed scenario that may be familiar to your imagination: at home, pain-free and peaceful, surrounded by loved ones.
But in reality, 70 percent of us are dying in hospitals and nursing homes, many after spending 10 days in an ICU undergoing invasive, sometimes painful, often expensive and futile interventions. Interventions that many may have chosen to forego if they had had meaningful conversations with their loved ones and health care providers along the way about their wishes.
Unfortunately, too many of us wait until it’s too late because we think it is too soon to bring up the topic. But when we delay, we risk leaving our loved ones in the dark to make decisions for us that they feel ill equipped to make. I’ve heard people say that they just wish they had had their mother’s or their father’s voice in their heads, saying what mattered most, so they could ground their answers to urgent questions from doctors in the Intensive Care Unit about “What should we do now?”
What is in our way? Is our fear really so great? Do inherited superstitions hold so much sway? I have heard otherwise rational people confess to thinking that if we talk about dying, it might happen sooner. Others say it just feels weird or that it is awkward to bring it up with your closest friends and family.
There are, no doubt, barriers to having conversations about the possibility that we may not always be in control. That is why I am grateful that congregations across America are taking up The Conversation Project on the invitation to teach and preach about the importance of talking about our wishes for end-of-life care during our faith engagement campaign, Conversation Sabbath, Nov. 11-20.
At Conversation Sabbath, people gather to celebrate and worship in churches and synagogues and temples — with a twist: This time they courageously welcome encouragement from their spiritual leaders and support from one another to reflect on what matters most at the end of life.
Using the “power of the pulpit,” clergy are uniquely positioned to change our cultural aversion to talking about the reality of our mortality. They will ground their messages in scripture and stories, ethics and anecdotes to encourage having crucial conversations about wishes for end-of-life care away from a hospital and in familiar settings like their congregations. Talking about our wishes matters, and it can start being a normalized conversation when we begin talking around our tables and not waiting until there is a medical crisis.
At the Conversation Project, we don’t think it’s a morbid conversation. If you ever saw our team working together, you might be surprised by the laughter, by the joy we find in our work. We see the life-affirming effect these crucial conversations are having on all the people in a circle of care. When we start talking about what might matter most to us at the end of life, we are sharing more than our thoughts and concerns about medical treatments. We are sharing who we are, who and what we love, what we value about living, and what legacy we hope to leave our loved ones and our communities.
I’m not saying it’s never sad. No amount of talking will take away the sadness of losing a beloved. However, if our loved ones know of our wishes, they can spend our last days savoring how we have lived, not worrying about how they think we would want to die.
Talking together, cultivating a subtle day-to-day awareness of our mortality, is a deeply spiritual practice. It’s a practice that nourishes a sense of awe and joy and gratitude for this one, unique, amazing life we have been given.
There is no cure for mortality. But there is the possibility that our aging and our dying can be blessed with a kind of healing wholeness when we restore these human events to their place in the sacred cycle of life.
We need courage and compassion to contemplate this mortal existence if we are to extract the blessings available in the intimate and essential conversations we need to be starting in the comfort of our homes and houses of worship.
The gift of accepting finitude, should we be willing to unpack it from the bubble wrap of avoidance and fear, is one that will give us more life right now. It allows us to leave this life not merely having visited this world, but having lived fully by having the best day possible each day. In the face of being mortal, let us bless one another with the gift of compassionate conversations. Through this gift, we leave a legacy that will be a blessing for generations.
The Rev. Rosemary Lloyd, BSN, MDiv, a former nurse and Unitarian Universalist minister, is the director and adviser to faith communities for The Conversation Project Institute for Healthcare Improvement.