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How to Have a Conversation About the End of Your Life




Give yourself and your loved ones a special gift by having a life care planning conversation, which Ellen Goodman, co-founder of The Conversation Project, calls “estate planning for the heart.”

Even though we know it’s beneficial, few of us have been willing to have the conversation. According to the California Healthcare Foundation, 90 percent of Americans say that talking to loved ones about end-of-life care is important, yet only 27 percent have actually done so.  Additionally, less than 30 percent have completed an Advance Healthcare Directive, which documents your choice of healthcare representative and specifies the end of life care you want to receive.

Linda Trowbridge, CEO of  Center for Elders’ Independence (CEI), a PACE health plan for East Bay seniors designed to help them continue to live at home, recommends starting the life care planning conversation early. “The minute a young person gets a driver’s license, parents should ask ‘who would you trust to make your decisions, if for some reason – like being in a car accident – you could not speak for yourself?’”

Trowbridge suggests that the conversation should continue throughout a lifetime, as answers often change when people age. “We have to get better at having this conversation. Injury and disease can happen at any point, and young or old, it’s best to be prepared,” adds Trowbridge. She urges families to talk about the details of what it means to be placed on life-sustaining treatment before being faced with that reality. “There are so many medical options that are now available people really need to understand the consequences of their decisions.

Alicia English, Director of Behavioral Health at CEI, suggests that the conversation consider “your values, what matters most to you, and what you would consider to be a good end to your life.”  She recommends that people ask themselves, “Who do I trust to carry out my wishes, even if they disagree with me? Talking with loved ones about what you want ahead of time helps ensure that your wishes will be honored,” added English.

Fortunately, excellent Bay Area resources are available to help initiate and guide this life care planning conversation. The East Bay Conversation Project, a coalition of healthcare providers, faith leaders, advocacy groups, and more, offers events and trainings to churches and community groups to promote engagement in life care planning. The organization’s free Conversation Starter Kit is a step-by-step guide to exploring personal beliefs and values about the dying process. Some people want all possible medical interventions, while others prefer to be at home, surrounded by the things that give them peace and joy.

English encourages seniors at CEI to “be brave enough to have these conversations” with their families about end-of-life considerations. She recommends GO WISH, a card game designed to help people discuss sensitive issues in a light-hearted way.

For information about Center for Elders’ Independence, visit or call (510) 433-1150.  For information about the East Bay Conversation Project, the Conversation Starter Kit, and Advance Healthcare Directive forms, visit To play the GO WISH game, visit

To read part 1 of the series, click here.


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