Discussions bring end-of-life issues to light

SANDPOINT - Nolan Redman needed to talk. As a Stage 4 cancer patient, he had plenty of questions and a lot on his mind. The close-at-hand prospect of dying, for instance.

What he found, when he mustered the courage to broach the subject in conversation, was that most people were terrified of the "D" word.

"You want to kill a conversation, start talking about death," said Redman, an Episcopal priest who leads worship services at the Holy Spirit Episcopal Church in Dover. "I even have clergy that avoid me. I think people just don't want to get into that conversation because of where it might go.

"My whole interest, once I was diagnosed, was that we need to start talking about this, because people are afraid to talk about death," he added.

"It's the ultimate elephant in the room," agreed Paul Graves, who also shares a background in the ministry.

Based on a 2012 health care survey, 60 percent of those questioned listed discussing end-of-life wishes with loved ones as being "extremely important." Only about 40 percent of those surveyed had done so.

Over lunch one Sunday, the two pastors and Redman's wife, Vira Melendez-Redman, batted around the what-if scenario of taking this topic to a bigger audience, opening it up to the community at large. Far from running from the opportunity, people turned out in force, with more than 110 participants taking part in a pair of Community Conversations to date.

The attendees included caregivers and family members who, like Redman, found themselves face-to-face with the reality of death, as well as the reality of society's aversion to discussing it. Facilitated by a panel that included a representative from Hospice, a psychologist and both Redman and Graves as pastors, the first two Community Conversations opened the floodgates of pent-up communication.

"Folks wanted to tell their stories and share what they're experiencing with loved ones," said Melendez-Redman, who also sat on the panel.

The first discussion centered on the topic: "Is there life before death?" A second session, held last month, delved deeper into end-of-life issues under the subject heading: "I don't know what to say."

As it happened, however, the folks that showed up had all kinds of things to say.

"We're not starting this conversation, we're just responding to the spirit that this is something people need to talk about," Redman said.

Most of the questions had to do with accessing Hospice care, the logistics of arranging for medical care and the availability of insurance coverage to help cover the costs. One of the best pieces of advice that came out of the sessions, according to Melendez-Redman, was that "showing up" for the dying person is one of the most important things anyone can do.

"A lot of times, you just need to be there," she said. "You don't necessarily have to say anything - it's OK not to say anything. You just hold vigil, if you will."

Which is entirely different from an inability to talk about death, Redman pointed out. He mentioned situations where families have refused to allow the topic to enter into their own conversations, often hobbling their ability to deal with the emotional and financial aftermath.

"And those are the families who are just devastated," he said. "When I grew up, death took place in hospitals and in hidden places. I'm concerned that we need to have some sort of cultural change in the way we approach death."

Doing so could empower the dying person at a time in life when they might otherwise feel helpless, the panel members said. Put a different way, it gives them a chance to take control of their life by taking control of their death.

"We all want that, even if it's no more than having a say in whether the service is the way you want it to be," said Graves.

"For Nolan and me, it's about doing this before you get to the death bed - and then starting to live your life," Melendez-Redman said. "We want to live to the fullest, because there's still so much to explore and discover."

According to Graves, the panel plans to stay together and facilitate future Community Conversations.

"We realized that, as a panel, we were modeling the kinds of conversations we would like other people to have," he said. "Whether it's around the kitchen table or elsewhere."

In Redman's case, the freedom that has come from opening the door to this difficult conversation has changed the way he lives each moment.

"I wish I had known when I was 20 what I know now," he said. "I'm actually in the best place I've been in my 73 years - spiritually, emotionally and, in a lot of ways, physically. My life is absolutely rich."

Before he was diagnosed with cancer, before he learned about Stage 4 and what that means in terms of limited life expectancy and low survival rates, Redman had tried retirement from the ministry for a short time. Now that he has acknowledged this elephant in the room and openly talks about his own death, he has been enlivened and enriched, the pastor explained.

"I tried the rocking chair for a little while and found it wasn't very comfortable," he said. "In fact, it was a great waste.

"My ideal death is that I would have led a worship service on Sunday - had another chance to serve - and then die on Monday or Tuesday."

He appears to be absolutely at ease - almost Buddha-like - as he recounts what his last seconds on Earth might look like. He is equally unshaken when asked if he harbors any fear of what happens after that final breath is drawn.

"Ah!" Redman exclaimed, breaking into a laugh. "That's what's so wonderful about it! It's such a complete mystery."

Much of the Community Conversations session topics have been based on the format used by a national group called The Conversation Project, which encourages taking the hard step of initiating "the talk" as a way to ensure that the end of life is in keeping with the dying person's wishes, not controlled by legal or medical professionals after they die. To learn more about resources available through this organization, visit their website at: www.theconversationproject.org

To be kept informed of future Community Conversations, call sponsoring organization Elder Advocates, Inc., at (208) 610-4971.