(End-of-life) Conversation Starter Kit (NYT, 8/17/12)

This post in today’s “The New Old Age” blog in the New York Times is about how to start the conversation with a loved one about advance care directives and end-of-life wishes.  One terrific conversation starter we’ve used in our family are the “Go Wish” cards.  (I got a couple of sets two years ago for $5 each from coalitionccc.org.)  At our recent PD/parkinsonism caregiver event in Foster City, Dr. Matt Arnold recommended the “Go Wish” cards as well.

Dr. Arnold also recommended the “Five Wishes” document, which we’ve talked about at local support group meetings for seven or eight years, after local support group member Storme first brought it to a meeting.  (See fivewishes.org.)

Though these resources have been around for awhile, as the blog post notes below, fewer than 40% of us seem to have advance care directives or living wills.

Now comes “The Conversation Project” — theconversationproject.org. You can view online their 10-page “Conversation Starter Kit” here:


If any of you end up using this kit, please let me know your thoughts on its value!

Here’s a link to the blog post:


The New Old Age: Caring and Coping
How Do You Want It to End?
By Paula Span
New York Times
August 17, 2012, 3:45 PM

Is “death rattle” horrible for dying person?

This is mostly a question for Bill, our resident hospice RN, but anyone is welcome to comment!

There’s an article in last weekend’s LA Times* about a woman whose husband was on hospice. She was very upset and he was very upset that his death didn’t come more quickly. When he did begin to actively die, he had a “death rattle.” She described the death rattle as “horrible.” And she described her husband’s death as “barbaric” — perhaps both because of the death rattle and because he didn’t die as quickly as he wanted. (I’m not sure.)

I remember when my father was nearing death, I was very worried about the “fish out of water” breathing that sometimes occurs with people. Seems like I was reassured at the time that this sort of breathing is far more disturbing to the bystanders than to the person experiencing it.

Bill – do we have any information as to whether the “death rattle” is “horrible” for the dying person? Does the “death rattle” indicate a person is suffering? Can Roxanol (liquid morphine) be given at the time? Does that resolve the “rattle”? What can bystanders do when they hear the “death rattle”?


* http://www.latimes.com/news/local/la-me … 125.column