The Conversation You Need to Have Now, Before it’s Too Late

By Garrick Colwell

Kinsloe and I were married on November 1, 2014. Beyond happy, we had come together late in life and were very much looking forward to spending the rest of our lives together. We saw ourselves traveling, working in the garden, holding hands, spending time with family, reading and just being with one another.

Twenty-two days later we were sitting in the oncologist’s exam room as he told Kinsloe that she had stage 4 cancer and might not be alive in six months. In that moment, our future changed forever. We were extremely confused. Now what? What are we going to do? We left the doctor’s office in shock.

At home we sat across from each other at the kitchen table and Kinsloe and I started talking. There were so many things to decide, so many issues to discuss, and so little time to do it. I took her hand in mine and sighed. We had to begin somewhere but under the circumstances, this conversation was tough. We asked ourselves: Where do we even begin?

The Right to Choose

As we talked, Kinsloe realized two very important things. First, it was her body, which meant it was her choice. She had the right to choose how she wanted to live the rest of her life. I sat there across from her at the table that day and agreed that she had the right to do things her way, to choose the healthcare professionals she would work with and her form of treatment and care.

Kinsloe’s second realization was that all her decisions needed to be based on what mattered most to her. So, she started making a list of things that she valued in her life. She would use this list to help inform her as she made day-to-day decisions as to how she wanted to live her life.

At the Kitchen Table

Warm and meaningful conversations take place at kitchen tables across America every day. It is a safe place for us to discover what we value as we explore how best to be human. When we talk about the future, we share our dreams—the company we want to start, why going to college makes sense, the person we want to marry and have kids with, and the beautiful house where we’ll raise our family. We talk about our adventures and mishaps, who we love and about those we’ve lost. As we age, our conversations turn to answering questions about the inevitable end of life. And sometimes, like with Kinsloe, it doesn’t seem that the time for these conversations could possibly have arrived—and yet it does.

As many people have discovered across American during this pandemic, there’s never a great time for these discussions. It’s always too early until it’s too late. Challenging as these conversations may be, discussing with loved ones how you chose to live at the end of life has proven to ease anxieties and reduce stress—for everyone. It’s better to have these conversations at the kitchen table than in the Intensive Care Unit during a medical crisis. Once you do, you can have peace of mind.

Where Do You Begin?

There are three important steps to consider:

Decide: The first step is to decide two things:
a) What matters most to you at the end of your life?
b) Who will speak for you if you are unable to speak for yourself?

How would you complete the statement: “What matters most to me at the end of life is…”? It’s important to take time to explore and discover your answers. Your answers will change over time, depending on your life experiences and your state of health. Knowing what matters most to you at the end of your life gives you a way of calibrating which treatments and what type of care you might want. Answering this question helps to loosen the fear of death, making more space in your heart and mind to focus on how you choose to live until your last breath.

Who will speak for you if you are unable to speak for yourself? It is important to choose wisely. The person needs to be someone willing and able to advocate for you. They should have the strength and courage to inform your medical team about your end-of-life choices. They are the person you will rely on to ensure your end-of-life wishes are honored and respected.

Discuss: The second step is learning how to discuss what your end-of-life choices are with your loved ones and health care professionals. You want to make sure everyone is on the same page. This will make decision making easier for everyone.

Document: The third step is to document your end-of-life choices. You want to make sure that you, your loved ones, and your healthcare professionals are on the same page—literally. The two most important documents are your Living Will and Medical Power of Attorney. These are legal documents but it’s not necessary to use an attorney to complete them. They become your Advance Care Directives. (You can access blank downloadable copies of these documents by Googling Advance Care Directives for your state.) Be sure to read and understand these documents before you sign them. Then, distribute a set to your Medical Power of Attorney, loved ones and healthcare professionals. And be sure to store them in a safe place that’s easy for others to access, like a file in your important papers or as a photo of each document on your cell phone.

Although having end-of-life conversations with yourself, your loved ones or your healthcare professionals can be challenging, the gift of clarity and peace of mind for all is well worth it. So, don’t wait—get started today deciding, discussing, and documenting your end-of-life choices.

Don’t Procrastinate: No doubt, talking about end-of-life choices can be tough. According to The Conversation Project 2013 National Survey, 90% of people say that talking with their loved ones about end-of-life care is important, but only 27% have done so. The result is that too many people are dying in ways they would not choose, often leaving loved ones feeling guilty and uncertain. The truth is, if you do not make your own choices about how you want to live at the end of your life, you burden your loved ones with making those decisions for you. Is that really fair? After all, it’s your life. Find free resources at KitchenTableConversations.org.

Garrick Colwell served as a patient advocate, fulltime caregiver and end-of-life companion for his late wife, Kinsloe. He has been a Hospice Volunteer since 1987, serving as an on-call hospital and hospice chaplain. He is a Respecting Choices® Advance Care Planning Certified Instructor and Facilitator and co-founder of Kitchen Table Conversations, an all-volunteer nonprofit providing educational resources that empower people to have end-of-life conversations. Contact him by email at garrick@KitchenTableConversations.org.

The Conversation You Need to Have Now, Before it’s Too Late