On a warm evening in late August, Betsy Trapasso, a 51-year-old former hospice social worker, gathered seven friends at a seafood restaurant in Topanga, Calif., for an unlikely purpose. She wanted to talk about death.
Over the course of the three-hour meal, with the Santa Monica Mountains as a backdrop, the friends discussed losing loved ones, the reasons why people find it so difficult to discuss death and dying, and how they wanted their own lives to end.
One dinner guest had recently become the caregiver for an elderly neighbor. When that neighbor had to be admitted to the hospital, Trapasso's friend didn't know if the person had made any decisions about whether to be kept on life support, which prompted much soul-searching. "My friend began thinking about what he wanted when his own time came," Trapasso recalls.
Trapasso and her friends aren't alone when it comes to discussing end-of-life issues in the open — more and more people across the country are asking each other similar questions. How much medical intervention do I want to keep me alive? Can I afford long-term medical care? Have I made sure that my family won't be financially burdened by my death? The fact that Americans are living longer than ever before, not to mention that many lack the savings to sustain a long retirement — let alone pricey long-term care — makes it more important than ever to pose these questions.
And, for many people these days, one effective way to share their very personal end-of-life decisions and desires with friends and family is to host "death dinners." The hope is that gathering over a meal will make discussing the topic of dying a little more palatable, while also sparing loved ones from fighting over financial and medical issues down the road.
"Financial issues at end of life cause so many problems and concerns for people," says Trapasso, who now works as an end-of-life guide. "I have seen people struggle with whether to leave money for their kids or do medical treatments. I've had men ask me if it was cheaper for them to just die, so their wives wouldn't lose the house. It astonished me."
Pass the casserole … and your health care proxy
Failing to plan or effectively communicate how you'd like to die can have major consequences. Most Americans say that they want to die at home — yet 75 percent of them do so in hospitals or nursing homes. And a FindLaw survey earlier this year found that less than one in three Americans has a living will, which can leave family members with the onus of having to make decisions about costly medical care.
"We live in a culture where we don't want to talk about the end of our lives," says 55-year-old Carole Fisher, chief executive of the Nathan Adelson Hospice in Las Vegas. "We spend so much time working on our health, our careers and our family — but when it comes to the end of our lives, we shy away from [the topic] because it is uncomfortable to talk about it."
As the head of a hospice, Fisher knows firsthand the importance of communicating end-of-life choices to family and friends. So while she was on vacation at the beach this past August, she gathered 16 friends and relatives over pizza to talk about death and how they'd like to die. To lighten the mood, she passed out adhesive mustaches to the assembled guests, who ranged in age from her five-year-old grandson to her 74-year-old mother.
The evening had its share of laughter and meaningful moments, but one announcement struck Fisher as particularly useful. "We are of the Jewish faith, and typically you aren't cremated," she says. "But my husband was insistent that he wants to be cremated. I knew that, but other family members — like his brother and his sister-in-law — were surprised. So that was helpful: If he goes before I do, and I say that we are cremating him, now there won't be any pushing back."
Fisher's gathering was just one of hundreds of death dinners held in 15 countries around the world on August 24 as part of a project called "Let's Have Dinner and Talk About Death." The brainchild of Michael Hebb, a teaching fellow at the University of Washington, the program encourages families and friends to have discussions about death around the dinner table. To help kick-start conversations, DeathOverDinner.org offers talking points, readings, and videos about death, as well as invitations for those interested in hosting their own gatherings.
"No one wants to talk about their own mortality," says Dianne Gray, president of the Elisabeth Kubler-Ross Foundation, a nonprofit focused on end-of-life issues that teamed up with Hebb to promote the dinners. "But if you can show you are doing it out of concern about doing what [family members] want, the safer they will feel."
Of course, initiating a conversation is a good first step — but it's also vitally important to formalize any decisions that are made, says Stephany Kirkpatrick, a Certified Financial Planner™ with LearnVest Planning Services. "I might have told my brother that I don't want end-of-life care," she says, "but my husband is the one who will be tasked with making health care decisions if I'm incapacitated. He may not agree with my decision, or never heard it, and now all of a sudden we have conflict."
That's why it's critical to consider creating a living will, either through a prepaid legal program with your employer, a private attorney, or an online service like LegalZoom. "Make sure that your health care proxy (the person you've chosen to make medical decisions for you in the event of an emergency) has a copy, and let them know if you update it," says Kirkpatrick. "In fact, take it out on an annual basis, and ask yourself: Is this still what I want?" And don't put off talking about these issues until you are older, adds Kirkpatrick, because "unexpected things can and will happen to you at any age."
A helping hand with end-of-life planning
There are a growing number of websites, like Everplans.com, that help people understand how much end-of-life planning they need, as well as offer checklists and other invaluable tools to help them accomplish their goals.
"This type of planning isn't morbid — it's responsible," says Abby Schneiderman, the founder of Everplans.com. After relying on a wealth of online resources to plan her wedding and prepare for the birth of her first child, Schneiderman was surprised by the lack of websites out there for people dealing with death. "I was struck by all of the wonderful tools out there for people who are going through very happy life transitions," she says. "But I asked myself, 'What's out there for people who are dealing with the unhappy life transitions?' "
That question took on tragic urgency when Schneiderman's brother was killed in a car accident in 2012. "All of a sudden, we weren't building a site for people who might die someday," she says. "Our goal became one of helping people sift through all of the overwhelming and complex information that accompanies end of life."
Today, Everplans provides advice on everything from writing a will and appointing a power of attorney to making funeral arrangements and settling the estates of loved ones. And the site will soon launch a service that will allow members to create a free Everplan online, where they can assess their end-of-life preparation, securely store important documents and access tools to complete the rest of their planning.
"If you don't have [these conversations], then your family is left to make decisions for you at a time when they shouldn't be — and they can be really expensive," says Schneiderman. "Plus, when someone you love dies, you're in a fog. It's not the best time to be making those decisions."
Kick-starting the death dinner conversation
If you want to host your own death dinner, but find it hard to broach the topic with family members, bring a bit of levity to the table, says Fisher. "I believe in a sense of humor, and any way that you can inject that is helpful."
Trapasso suggests taking advantage of the literary passages and videos available on the Death Over Dinner website as a way to "break the ice." But she cautions that "the most important thing is not to push. If people want to be silent, let them be silent. It can take them time to get comfortable with the topic."
But no matter the response, it's critical to keep trying to talk about death and dying. "This is not about having one conversation," says Gray. "People change. Situations shift. If you talked to a parent two years ago when he or she was diagnosed [with an illness], they might feel differently now."
Fisher says that she already senses that her family's recent death dinner has helped them tackle the taboo aspect of death. "The most fascinating thing was that it opened the door for other conversations the day after and the day after that," she says. "I didn't think that was going to happen, but it started a dialogue about things that people don't like to talk about."
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