We Need To Talk About How You Want To Die

It’s a discussion that most people avoid: end-of-life planning.

Doctors say it’s important to have these conversations while you’re still able. But let’s face it, talking about advanced directives can be uncomfortable, even terrifying.

More often, it's a medical crisis that forces families to talk about their loved ones’ wishes. Dr. Joanne Roberts of Providence Hospital in Everett has seen this many times. She said the typical situation would be someone had a stroke, the caregivers who live nearby are at the hospital and the kids who live out of town fly in.

“Everybody’s at the bedside and they’re arguing over what did mom hope for,” Roberts said. “How did mom want to live the rest of her life? Well, she never talked to us about that.”

Roberts, the chief medical officer at Providence, previously practiced hospice and palliative care medicine. The back of her business card has three questions printed: "Tell me what you hope for | Tell me what you’re afraid of | Tell me how you want to live the rest of your life." Imagine, Roberts said, what kind of conversation that would be.

Roberts said it’s her dream that doctors and patients have conversations around these questions. The goal is to encourage people to make a plan for end-of-life care and to share those plans with their families and doctors. To that end, the Washington State Hospital Association and Washington State Medical Association have started a campaign called Honoring Choices. Its website offers resources, and a kit for opening the dialogue.

Roberts knows from personal experience that it’s tough to have these conversations. Her own mother made her wishes very clear early on.

“I can give you her exact words: ‘I don’t want to live on no damn machine,’” Roberts said. But Roberts, who was in her early 20s at the time, didn’t want to hear it. “She used to drive me crazy talking about this stuff,” she said. “I hated it.”

Yet, the message stuck with her. Years later, her mother was in the hospital. She had heart failure.

“She was 80, and she was clearly dying,” Roberts said. “One day, in comes a surgeon to her room and said, ‘Gosh, we can put in one of those devices to make your heart beat stronger.’”

Her mother mentioned this to Roberts and briefly considered the procedure. Roberts reminded her mother what she had said in years past.

“I was able to say, ‘Well mom, does that fit with what you had told me over all these years?” Roberts said. “And she reflected and said, ‘No it doesn’t at all. Of course not.’ And it helped her make a decision. And she died a couple of days later.”

Roberts has started a conversation with her own children. Her older daughter, who is in her early 20s, isn’t eager about it. Roberts chuckles; her daughter is reacting the same way Roberts did with her mother.