Breaking bread, and end-of-life barriers


Civil rights, feminism, the anti-Vietnam War movement, gay rights, rights for the disabled. Given what’s happened in those areas during the six decades baby boomers have monopolized the nation’s cultural, political and economic landscape, it’s not surprising that many researchers characterize boomers, and that includes me, as positive social and political rabble-rousers.

Yet any shorthand generalization of 78 million people born between 1946 and 1964 is fraught with minefields and bound to leave some people wondering whether such a glowing social change characterization of the generation is fair. Yes, all people should have equal rights and a war with no meaningful purpose should have never been fought.

But keep in mind boomers created a national debt of more than $17 trillion that will take generations to pay off. And it was boomers in the ’70s — supposedly disillusioned by the Vietnam War and a dire economy — who also became the “Me” and “Now” generations that got too many hooked on drugs, and who introduced a sexual revolution that has had a lot do with far too many children today not having a mother and father in the household.

Still, even the most conservative soul’s reading of American history should conclude that boomers reshaped societal norms, for better or worse, by repeated challenges to the status quo.

Now, as many boomers inch closer to the end — each day 10,000 more turn 65 — they’re challenging the status quo again. This time on how to die.

It is becoming increasingly clear, according to Carole Fisher, CEO of the Nathan Adelson Hospice in Las Vegas, that boomers don’t want to repeat the experience of earlier generations, of stoically accepting painful life-extending medical interventions and enduring suffering with a future of only enduring more suffering and incapacitation.

“They still want to call the shots as much as possible,” Fisher said. “And when it comes to death, that means communicating what your desires are ahead of time.”

Dianne Gray, president of the Elisabeth Kubler-Ross Foundation, a nonprofit focused on end-of-life issues, says thousands of boomers nationwide are organizing “death dinners” to talk about death in hopes of defusing possible family conflicts over medical care and finances — and avoiding unnecessary agony at the end of life.

The people organizing these dinners are often, Gray said, people who’ve have seen loved ones die after suffering for far too long on feeding tubes and ventilators, with a family often divided on whether to pull the plug or not.

Studies have repeatedly shown that only about 25 percent of adults have a living will or advanced directive, a legal document spelling out the medical interventions they’d want or not want if unable to communicate. Less than 70 percent of Americans 65 and older have a will detailing where the assets should go. Death dinners, Gray said, are starting to change those numbers and often are the catalyst for wishes being legally formalized.

If documents aren’t filed and discussions aren’t held before a loved one’s illness or death, she said, families often are split as to what to do and get into emotional battles. The hard feelings can last for years.

“It can get very ugly,” Gray said. “Even though I’m in the field, I’m sorry to say my own family has gone through some things. It’s very unfortunate and a horrible legacy for the loved one who died. That’s a time when people should be close.”

Fisher’s family, four generations of it, held a death dinner last year. Fisher, whose family was still smarting from the deaths of two loved ones, handed out fake mustaches to help lighten the mood.

“That was the first time my mother told the entire family she didn’t want interventions to prolong her life and it also was the first time my husband said he wanted to be cremated,” Fisher said. “I’m so glad my husband’s brother was there. There could have been some real family drama down the line otherwise.

“In the Jewish religion, cremations are forbidden. But that’s what Gary wants,” Fisher added. “Now his brother, who’s very religious, can’t dispute it. He’ll honor Gary’s wishes.”

If end-of-life issues aren’t known or agreed upon, doctors can also get pulled into tragic situations, says Dr. Dale Carrison, head of emergency at University Medical Center. Because a frail 90-year-old woman hadn’t filed a living will and her family was bitterly divided on what to do — doctors had delicately told loved ones she had no chance to live from her cardiac distress — Carrison had to do CPR, hearing her ribs break as he performed the procedure.

“I felt terrible hurting her like that,” he said. “She lived on life support until the family finally decided to cut it off. Unfortunately, doctors see these sad situations a lot.”

A discussion with two doctors who said Americans weren’t dying as they wanted prompted Seattle culinary impresario Michael Hebb to come up with the idea of death dinners, a concept Gray’s organization has supported. If you visit www.deathoverdinner.org, you’ll find ideas on how to word a death dinner invitation and talking points for the dinner.

At 55, baby boomer Fisher thinks that if her generation is remembered for promoting dinners that help to ensure that people die with the dignity they want and let families escape the friction that too often accompanies end-of-life decisions, that will be a legacy of social change no one can criticize.

“Celebrating the end of our lives with planning and compassion makes so much sense,” she said. “And something else happens at those dinners. You also end up honoring those not with us, sharing wonderful memories, toasting them. It becomes a celebration of a family.”

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.