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Q. When is the right time and place?

Well, it's never too soon. That's one thing I'm sure of. The first place for the talk is not the doctor's office and certainly not the emergency room. It's at the kitchen table long before a medical crisis. If you're the parent, begin by having the conversation in your head, because talking it out with yourself will make it easier to approach your children.

Ask yourself: What central experiences color my hopes and fears for the way my life will end? Am I afraid that I won't get enough care—or too much undesired care? Whom do I want to make decisions for me if I'm not able? Do I want that person to follow my instructions exactly or do what he or she thinks is best? If I'm dying, would I rather be at home or in a hospital?

Imagine you are seriously ill, and finish this sentence about living: I want to live as long as I am able to...

Now finish this sentence about your death: I want mine to be...

If you're the daughter or son, you might want to begin by asking for advice. You can say, truthfully, "I'm worried about what might happen if you're ill and I have to make decisions for you. Can you help me?"

Q. Any other tips for broaching the subject?

Whether you're sharing your wishes or need to hear from your parents, start by bringing up a memory, a statistic, an article—even this one. Try to remember that these are not Grim Reaper talks. They're not discussions about what's the matter with you. They are about what matters to you. How you want the end of your life to reflect the whole of it. As many people have told us, these conversations produce rich moments of emotional connection. They bring us closer together. What's more, people who have had them tend to choose less aggressive care and leave their survivors less regretful and depressed. What a gift!

Q. What will it take to normalize these talks?

It's not easy to change a cultural norm, but women have done it before. We're the ones who transformed birth in America. It wasn't doctors who got rid of stirrups and welcomed men into the delivery room—we did it. Once people only whispered the word cancer. Now we march for cures. Women have been major change agents over the last half century, and in our new role as eldercare givers we can do it again.

Keep Reading: Read the dialogue between Goodman and her 44-year-old daughter, Katie, as they discuss end-of-life wishes

Ready to talk but not sure where to begin? Go to theconversationproject.org, where you'll find a starter kit to help guide you to the table.

More on Mother-Daughter Relationships
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Published on September 17, 2012
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