Tackling challenges to initiating conversations: Part II

If you or someone you know in your community has trouble initiating end-of-life conversations, you certainly are not alone! In our earlier blog: Tackling challenges to initiating conversations: Part I,  we shared several resources and ideas from communities we work with to help tackle the top challenge cited: discomfort and not knowing how to start.  Another frequently cited challenge we are hearing from communities is that individual beliefs (personal, cultural, religious) may be holding us or others back.

9 TCP resources and a sampling of 5 other community resources to help address personal, cultural or religious beliefs

One of the most frequently cited false beliefs is that advance care planning is only for those nearing end-of-life (e.g. older ages). Many of The Conversation Project (TCP)’s community champions are tackling this belief head on by engaging anyone over the age of 18. In fact, several are tapping youth to not only equip them with the knowledge and skills to have these conversations now, but also to serve as “ambassadors” to help spread the word. One volunteer noted wisely that “youth don’t hold the same taboos as elders” when it comes to talking about end-of-life. We have collected several stories that you can use to help counter this belief in your family or community!

• Click here to read two first-hand experiences of how millennials/college students are turning this once steadfast assumption right on its head.
• Check out our new guide to reach college students.
• Read this case study and video clip from St. Charles Health System to find out how bringing education to youth can help start these conversations early, alleviating fears and empowering youth.
• Check out this video of TCP community champion Tiffany Callender explaining why the Horizon Foundation is leading community-based efforts to normalize end-of-life conversations for anyone over age 18.
• Listen to Joan Gibson of The Conversation Project in New Mexico share a poignant story about organ donation to illustrate why it’s important to engage youth in conversations.

Another common barrier is that ever present (no matter what your age) fear of death.

• Read how one woman tackled her feelings of fear and chose action instead.

Cultural or religious beliefs also hold some back from initiating conversations. These beliefs need to be approached with humility, respect and understanding as we work to bridge the gap between beliefs and conversations. If you are doing community work, get familiar with the demographic make-up of your community as a first step. Every community will approach this differently so look inside your own to find the answers.  We have several resources below that could help but this is by no means exhaustive!

• Stanford Medicine and their Geriatrics Education Center provides a wealth of resources on cultural and spiritual diversity in end-of-life care, including several training modules on health and health beliefs of various cultures to help you get familiar with some examples.
• Harborview Medical Center in Washington state developed an ethnic medicine website, EthnoMed, to make information about culture, language, health, illness and community resources directly accessible to health care providers. Among their resources is this comprehensive article: Cultural Relevance in End-of-Life care. Well worth reviewing!
• Several of our community champions are working side-by-side with their faith communities to bridge this gap: read more in this case study from the Institute for Human Caring at Providence St. Joseph Health (see also St. Charles Health System case study link above for ways they are engaging with Faith).
• TCP also has a host of resources to help those in, or wanting to work with those in, faith settings to help preach, teach and help support individuals to link their faith beliefs with intrinsic motivation to start these conversations. Check out our Faith resources (Getting started in congregations, preaching and programs) here.
• Listen to Reverend Gloria White-Hammond, Co-Pastor at Bethel AME Church in Boston, shares how to bring clinicians and people of faith together, here.
• Another resource from Stanford that addresses the above two challenges is a program they’ve created that teaches high school students to serve as cultural ambassadors.
• The Chinese American Coalition for Compassionate Care, formed to address the lack of linguistically and culturally appropriate end-of-life information and training available to the Chinese community and those who serve it, has developed a special bi-lingual deck of playing cards and an accompanying workshop, called Heart to Heart® Cafés, that help prompt a values-based discussion around end-of-life through a card game. As playing cards are a universal draw in the Chinese community, this game helps provide an entry point for family members to discuss this topic, as conversations about death are usually taboo.

What are you hearing or doing to tackle these challenges to initiating conversations?

We know there are many more fabulous examples out there – please share yours here! What lessons can you share from personal or work experience that could help us/others take culture, religious, and personal beliefs into account and better support conversations that may otherwise seem taboo?