Talking about death might not be the ideal way to spend Mother's Day, but after taking my mom out for a nice lunch, that's exactly what we did.
It's not that the Grim Reaper is in residence. My mother, Geneva Meehan, is 84 and has taken good care of herself. She did Jazzercise for 26 years and regularly rides an ancient stationary bike. She's healthier than most of her six children. Sometimes it's hard to get on her calendar because it is filled with church activities and volunteer work.
But she is going to die. Someday. I hope it happens many years from now. But it will happen.
So we had The Conversation.
Another part of life
I learned about The Conversation Project while at a nine-day HealthCare Coverage Fellowship in Boston, where journalists from around the country were educated on a wide range of health care matters.
Ellen Goodman, the former Boston Globe columnist, was our first speaker. To be honest, when I heard her speak enthusiastically about talking about dying, I was not all in.
But as Goodman explained how she came to see end-of-life care as an important national issue, I got a better understanding.
The nonprofit effort aimed at promoting end-of-life discussions grew in part out of her experience. She was working on deadline when she got a call from a nurse. Goodman's 92-year-old mother, who suffered from dementia, had pneumonia. The nurse wanted to know whether Goodman wanted her mother to be given an antibiotic. Without it, her mother probably would die.
Such a life-or-death decision, Goodman said, shouldn't be made on the fly. In that instance, the medicine was provided.
Goodman's mother died in 2006, and one of Goodman's continuing regrets is that she was unable to help fulfill one of her last wishes: to die at home.
According to the Centers for Disease Control and Prevention, 70 percent of people say they don't want to die in a hospital or nursing homoe. But, the research showed, that's where 70 percent of people die.
That doesn't have to happen if people make decisions that can help their wishes be carried out and think about death as another part of life, Goodman said. Since the project started in 2010, a "starter kit" with questions and ideas on how to broach the topic has been created, a website shares individual real-life stories, and events have been organized. All of it is focused on having The Conversation.
Mom proves game
As soon as Goodman's session was over, I called my mom.
I was pretty sure she'd be game to have The Conversation. Lately, she talks more about her death, not in a dramatic way, but it seems to be on her mind. I guess that's natural because she is outliving many friends.
Nearly every time I see her, she mentions what she doesn't want in her obituary. I wrote my Dad's for him before he died and have promised to do the same for her. She wants to be sure it is not florid or overdone, or too boastful.
She also has commanded that there be no speeches or tears at her memorial service. When I tell her she can't dictate how we grieve and joke that she'll be gone anyway, she laughs.
When I told her about The Conversation, she wanted to do it right then, over the phone. We decided it would be better face to face, and Mother's Day was the next time I would see her.
I'll admit that when I printed out The Conversation Starter Kit from the Web, I got a little choked up. It sat on my desk for days before I looked at it. I tend to put things off that are out of my comfort zone. I thought it was an important conversation to have, but I don't like thinking of my life without Mom.
'Do you want to know why?'
I joke sometimes about putting on a "reporter's cape" when work requires me to tread into uncomfortable territory. I guess I did that as I sat in Mom's living room and started asking questions about dying, much the same way I have asked thousands of people over the years about their lives.
First off, she said, people don't want to talk about dying because they don't want to talk about getting old. "As a society, we've made old people ugly and death an ugly thing," she said. "It's a part of life."
The starter kit laid out big issues, such as how much she would want to know about her declining health, which you rate on a scale of 1 to 5. The higher the number, the more information and communication you want. My mom was a consistent 5.
After almost every question, she'd give her rating and add, without being prompted, "Do you want to know why?"
For example, she would want to know as much as she could about her condition so she would know the cause of her problem and whether there was something she could do to help herself.
She would want to know whether she had a limited time left, because "I think we always have some regrets, and there is always a possibility that there would be time to address them."
Quality of life is more important than quantity, she said. We even talked about the specific question of pneumonia. She said she'd been told by a friend who is a nurse that pneumonia is "the elderly person's friend" because it can push a worn-out body to the brink instead of allowing a lingering half-life.
"If I got pneumonia today," she said, crocheting a blanket most likely to donate to charity, "I would want an antibiotic."
But there might be a day when that answer would be different. And when that time comes, she said, "I want to have a say in every decision."
There was a little more ambiguity about who would care for her and where. She wouldn't commit, at first, to having one of us kids take care of her, but she said she didn't want to take over anyone's life. She didn't want to be a burden. She didn't want to commit to hiring someone, because it would eat into our inheritance.
She seemed to soften a little when I told her that we would work it out if someone needed to be there, she should let us help, and it was her money and she should spend it on herself.
There were too many variables to make some concrete decisions now, she said. But she wants her ashes put in a cardboard box and sprinkled on a field of blue cornflowers.
Helping each other
We got through the starter-kit questions in less than an hour. The kit suggests that you might have several conversations if things get too difficult. It also provides a framework to start with, and it was helpful to say to her, "There's this thing called The Conversation Project" as an excuse to start the dialogue.
Goodman thinks such individual conversations will help change how death is handled in America. Baby boomers are hitting retirement age at a rate of 10,000 a day. Boomers have had a cultural impact all of their lives, she said. They can help change the way America views and discusses death.
My mom and I have done our part, I guess. I'll give my five brothers and sisters the option to read this, talk to me or, better yet, talk to Mom.
My mother has a living will, and she has set up a health care surrogate, my oldest sister, who is a nurse. But I wasn't sure how much she'd thought things through. I wanted to make sure she understood that there were incremental steps in which decisions might need to be made that didn't involve "pulling the plug." I also wanted to be well informed in preparation for what will be a difficult process, no matter how many conversations there are.
The last question was how you felt about The Conversation. My mom, the caregiver that she is, said, "I feel like it helped you to feel better."
But she seemed to like making her wishes known. She softened a little on her "no mourning" stance and conceded that she might let folks help her a little more than she has. To deny that, she said, is to deny somebody a chance to show their love.
So in her eyes, she helped me. In mine, we helped each other. And although tears still come to me at the thought of her death, we are both a little better prepared for it. So in the end, it was a conversation about life and love, and how you can best show it in trying times.
Maybe it was appropriate for Mother's Day after all.