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Once I began my journey as a guide for people to get their lives in order before they get really sick or die, I have had amazing experiences. I have asked many doctors why it is so difficult for them to discuss death and dying with their patients. They do realize we will all die eventually, even my 100 year old mom who we have decided is the energizer bunny with a forever battery, right? I have experienced my husband dying four times in the last 15 years. Really. The doctors have called me in and begun the conversation, "Tina, I am so sorry..." right out of the Hallmark movies. I now interrupt and ask, "Should I call my children?". When they say yes, I know it is a serious incident. But having a conversation about what we do next, what to expect,- the worst, the best and the most likely,- is impossible. One doctor even asked me about one of Bob's organs and why didn't I inform him it was releasing too much of the hormone it created! I didn't even know where it was, much less what it did! And I did not go to medical school. If I had, I would have received little if any training in how to discuss my patients' dying.

I do not mean to infer that doctors are not terrific at what they do. They are and if I need surgery or treatment, I want the most experienced with the best credentials. However, part of living is the reality that there is an end date to this adventure. I can never know the when, but I do know the end of life here will happen. And I think, am truly convinced, that planning for that end a little will make it easier for me to leave as I wish and my family will have a tool to help them navigate the unknown.

I have learned it is best to be proactive when discussing my decisions with my family and medical team.

This isn't easy. I'm not dwelling on my death. I'm very excited about my living for many more years and living vibrantly and out loud. And I do have specific wishes about how I want to be treated, talked to. and respected as I encounter illness, older age and dying. One guide I found helpful is YOUR CONVERSATION STARTER KIT. This is created by the Conversation Project and Institute for Healthcare Improvement. It is available at This is a wonderful way to begin. And be sure to share it with your doctor as well as your family.

I would enjoy you emailing me your experiences and ideas about how to be heard concerning your wishes for your death. Most of us want to die at home and 85% die in and ICU. We better get talking.

Take good care!


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