Asking loved ones how they wish to live out their last days will never be easy. But the Boston-based Conversation Project, co-founded by former Globe columnist Ellen Goodman, has launched a national effort to encourage families to have forthright discussions when members near the end of life. A 2009 study by Dana-Farber Cancer Institute found that patients who had end-of-life discussions were more likely to die in familiar, loving surroundings at home than in intensive care units, and they incurred significantly fewer health care costs as well. Under the best of circumstances, dying patients can feel confident that their families understand their wishes about how long to continue medical treatment — and survivors get the reassurance of knowing they’ve honored those wishes.
In the process, there may be stories shared that would otherwise be lost, final laughs, and reconciliations of old wounds. “You can’t change the amount of grief, but you can change the level of depression, anxiety, and guilt about how family members handle things,” said Goodman, who started the project partially because she did not talk to her mother about her wishes before she faded away with dementia. The need for families to have the conversation is clear because doctors still find it difficult to. A Dana-Farber study this year found that even incurable cancer patients have end-of-life discussions with their doctors a median of 33 days before death. For most families, that’s simply too short a time to work through these highly emotional issues.