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You should talk about death long before anyone is sick

It’s rarely soothing when a loved one says, “Can we talk?”

Those three words often lead to uncomfortable discussions about breakups, money issues, work problems, or – most terrifying of all – matters of life or death.

When my mother was diagnosed with stage 4 colon cancer in the spring of 2015, we avoided any discussion of death or palliative care decisions.

We wanted her to live, so we focused on hope. Nearly four years later, when my mom was going into hospice, I would wish we’d had those discussions we were so afraid to bring up.

In most Western cultures, and definitely, in the US and the UK, we are experts at avoiding grief and death. We tuck it away, flee from it, and change the subject with swift desperation whenever it comes up.

“I’m dying.”

“Lovely weather today!”

Or…

“I have six months to live.”

“Pass the parsnips!”

Okay, maybe our avoidance isn’t that extreme, but it’s close.

As I write in my book So Sorry For Your Loss: How I Learned To Live With Grief and Other Grave Concerns, my sisters and I were terrified to bring any of these things up with our mum.

How could we take away even an ounce of the hope she had, or the hope we clung to, that she would make it through, and somehow beat a diagnosis that, for most, is terminal?

During the course of writing the book, I spoke to several palliative care physicians and end-of-life advocates who said that, if possible, having talks with loved ones about end of life decisions should happen long before anyone is sick.

That way, you don’t have the painful emotions and fear that can make these discussions so fraught.

I interviewed Dr Melissa Wachterman, a palliative care physician at Harvard Medical School, and told her about my family’s fears.

She said that when she brings up emotional subjects, she tells the patient, “We’re going to go somewhere scary for a moment, but you’re not there yet. We’re going to open this box and peek inside, and then we can close the box.”

I wish I’d had those words when my mum was alive, since it may have made our experience at the end of her life a little bit easier.

Instead, we were completely unprepared for the paperwork, the bureaucracy, and the decisions about whether to bring her home to die or stay in hospital.

It still would have been extremely emotional, but maybe if we’d opened that box and peeked inside, it would have eased even a tiny portion of the pain.

Now, I tell my husband that we should talk about these things while we’re still young and healthy before anyone is sick.

It’s less scary, less immediate, and we know we can close that box for as long as we like. Hopefully, for years to come.

Dina Gachman is a Pulitzer Center Grantee, an award-winning journalist, and the author of So Sorry For Your Loss: How I Learned To Live With Grief, and Other Grave Concerns.

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