No one wants to talk about death, but everybody needs to talk to their families about dying.
This is the message that Shahid Aziz hopes to impart during the fourth of five weekly sessions of “Courageous Conversations About Death and Dying: Now is the Time” at 3:30 p.m. today in the Presbyterian House chapel.
“It’s a journey we all have to take, and for any important journey we all plan like crazy,” Aziz said. “This is one journey we all need to plan. And since we don’t know when we’re going to take this journey, we need to plan now so you’ll have the journey the way you want it. You never know when you’re going to lose your ability to make decisions.”
The seminar will consist of a presentation by Aziz about the process of creating an advanced directive, or living will, by deciding what mental and physical thresholds are required by an individual for a meaningful life.
These thresholds might include the loss of speech, ability to swallow or ability to recognize family, after which an individual would no longer want their lives to be prolonged through medical intervention.
“We know we can’t stop [the terminally ill] from dying — we can only prolong their dying,” Aziz said. “If I’m helping to prolong your life, how meaningful is that life to you? If it’s not meaningful, then I’m only prolonging your dying process and prolonging your suffering.”
The program will also include a role-played conversation about these physical and mental thresholds between Aziz and an attendee.
Aziz said the demonstration is meant to show how simple such discussions can be, as they do not require the presence of a lawyer and only need to cover three topics: the minimum mental functioning, the minimum physical capacity, and which medical treatments that are acceptable to the individual in question.
“If everybody answered those three questions in the USA, the end-of-life decision-making would be so much easier, people won’t get unnecessary treatment, and the cost of health care would go way down,” Aziz said.
In addition to the seminar, Aziz will lead a smaller discussion at 1 p.m. Tuesday in the Presbyterian chapel to allow for a more personal, in-depth conversation.
Aziz said the community response through the first three weeks has been largely positive.
“It was extremely helpful in enabling us to help our children better manage the end of life experience,” said Walt Grosjean, who attended Aziz’s July 13 seminar with his wife. “It also helped us to set our own personal standards for the type and extent of medical care we would want or not want at the end of our lives.”
Though the conversation in both the seminar and small group is not religious, Associate Director of Religion Maureen Rovegno said her department sponsored the discussion because they cover “the full spectrum of life, including death.”
“Last year, we did a week [of Interfaith Lectures] on ‘From Here to Hereafter: Facing Death with Hope and Courage,’ ” Rovegno said. “And when Rebecca Brown did the Monday keynote, she just knocked people over with her fabulous message about understanding death in relation to life, honoring and respecting death as opposed to fearing it, and deconstructing our culture’s death phobia. It really struck a chord, and we realized we needed to do something more actively here [on the subject of death].”
Andrew Dickson, of Hospice Chautauqua County, has been in attendance for these seminars to represent his organization. Dickson said if more people completed advanced directives in the way Aziz advises, end-of-life care would become much simpler.
“[Hospice] comes into people’s lives when things are most stressful and emotionally draining,” Dickson said. “We step into this, and it’s a minefield. We’ve got to sort it out. Our social workers mediate these sorts of discussions and disagreements between family members when it’s too late, when we can only try to make peace.”
Dickson said while Hospice Chautauqua County has served the Institution with bereavement counseling and other assistance for years, seminars like this one are needed long before hospice is called in.
“As a society, we’ve got a long way to go before these kinds of conversations are happening on a regular basis without Dr. Aziz and without Chautauqua Institution sponsoring programs like this,” he said. “Chautauquans are above-average people. Maybe we’re preaching to the converted, but it’s still such an important subject.”
No matter how these conversations are held, Dickson said the advanced directives were not only practical, but a gift to the individual’s family members.
“I’ve never found an attorney or a health care provider that will say that advance directives are a bad idea. Nobody,” he said. “It’s a roadmap, and it’s a gift. It’s a little bit of sanity in an otherwise completely insane time. And not enough people have had these discussions.”