Having the talk: Conversation starters for advance care planning

On National Advance Care Planning Day 2019, Dying With Dignity Canada’s Digital Communications Coordinator Rachel Phan asked supporters for help in getting her advance care planning conversations started. In response, nearly 200 of our supporters across the country submitted stories about how they started these difficult, but important, conversations with their family and friends.

We’ve compiled a small sample of those responses with the hope that they’ll be as helpful to you and your loved ones as they’ve been to Rachel and our team.

Give loved ones time and space

Lynn from Ridgeway, Ont.: Let your loved one know in advance that you would like to talk about your advance care planning. I like to walk or share food during these talks as it helps to take away some of the tension. Plan more talks in the future, and thank your loved one for listening and supporting you.

Carole from Richmond, B.C.: Pick the time carefully; the other person shouldn’t be dealing with work-related or personal “extra” stress. Follow up at the appropriate time to check that the other person is handling what you said.

Sue from Sidney, B.C.: Start with small little “paving bricks” ahead of the “big path” speech. Of course you must have your own vision, and then goals, evolved into an overall direction for your path before the conversation. Leave enough room for others to express their feelings.

Reference a story in the news

Jeannine from Saskatoon: “I heard an item on CBC the other day.” My family knows that I take most CBC info as gospel. When I heard them say that families that have not talked in advance are often torn apart when the crisis hits and some never repair the damage — that got us going!

Kate from Oakville, Ont.: During the passage of the bill legislating medical assistance in dying (MAID), we posed the hypothetical question with the family about how each person would alter the bill if he/she could write it themselves. This started out by considering all Canadians and then personal feelings came about.

Read and recommend a book

Jane from Toronto: I want to recommend an excellent book by a doctor called Being Mortal: Medicine and What Matters in the End. The author’s name is Dr. Atul Gawande.

Barrie from Gabriola, B.C. A book called Can’t We Talk About Something More Pleasant? by Roz Chast.

Peg from New Mexico Using suggestions from the book Let’s Talk About Death (Over Dinner) by Michael Hebb.

Talk about someone you know

Hélène from Montreal: Every now and then I would comment on people we know who have become dependent on their children. Their quality of life is not what I want for myself, and I tell my daughters that I don’t want to be a burden for them. I want to be able to end my life on my own terms and they agree with me.

Greta from Montreal: I started the conversation by talking about the arrangements (or lack of appropriate arrangements) of several of my friends who had died. I asked my children what they would want for me in terms of quality of life while I am alive and end of life when it comes or seems like a good idea.

Wilf from Kingston, Ont.: Every now and then there is a funeral. The conversation at a funeral often covers end-of-life choices, and that makes it easy to segue into your own personal choices.

Start a conversation about logistics

Anonymous from B.C.:  At a family visit, I suggested my family first talk together about anything they would like from my place when I die, as downsizing will be in the cards in the near future.

Pashta from Victoria, B.C.: Sometimes I find it easiest to start advance care planning by talking about the funeral service. I realize that this seems backwards, but if this is more comfortable for them, then we work back to the possibility of a home funeral, pre-death wishes, and then advance care planning.

Darlene from Calgary: We first talked about organ donation that is marked on our driver’s licenses. It was easy to bring up the medical assistance in dying option.

Get creative

Kathy from Toronto: I ask the person I’m speaking with to fill in the blank: “I want to _____ until I die.” We’re starting the conversation on a positive note.

Ann from Upper Fraser, B.C.: For Christmas one year, my mother gave her children a strange gift: she made arrangements for her own funeral. This certainly opened up the discussion regarding dying.

Val from Ottawa: Humour is a really big help! How about, “Let’s talk about croaking. I’ve got some things I’d like to say.”

Bring up Dying With Dignity Canada

Bevan from South Bruce Peninsula, Ont.: I have made some donations to Dying With Dignity in the past. Now, every time I receive an email I exclaim out loud, “There’s another email from these guys. Now what are they on about?” This is a great conversation starter around the room and everyone is able to express their views.

Zelda from North York, Ont. I joined Dying With Dignity Canada and explained this organization to my husband and sons when I was in my eighties. At that time, I spoke to my doctor as well as my family and explained how I wanted my death to be handled.

Jenny from Edmonton: I think sharing [the responses to] this email is a wonderful conversation starter.

We hope these DWDC supporter suggestions inspire and empower you! Please remember that there is no “right” way to get the conversation started and that it might take a few tries to get things going.

If you’ve had these advance care planning discussions with your loved ones, please let us know in the comments below how you got your conversations started!