I received a packet in the mail some months ago.  It was from my sister. I opened the thick manila envelope to find a stack of papers with a little purple post-it attached.  "Not to worry.  There is nothing wrong with my health.  It is just time I thought about such things.  Please sign on the highlighted lines and send this back to me."   She even drew a little smiley face at the end. 

When I lifted up the purple note I found my sister's living will. 

An audible groan escaped from my lips as I quickly stuffed the papers back into the envelope and hid it from view.  Let's just say that discussions of death make me feel very uncomfortable.  It isn't like I haven't thought about death.  As a person who suffers from depression I have thought about it a lot.  I have thought about people I have lost.  I have pondered my own mortality.  I have felt the terrible fear of the unknown. I have even wondered what it might be like to not exist.  I have explored death in an existential and emotional way.  But I have been most resistant to ever discussing death in any logical or practical way as in end of life wishes.

It took several days before I was able to pick up my sister's papers.  I began to read.  There were some things I didn't know or would not have guessed.  It was emotionally difficult to read her will but in another way it was strangely comforting.  There would be no second guessing of what to do.  My sister's wishes were all clearly spelled out.  I called her on the phone after signing the document.  I had to hear her voice.

"Well my plan is... I will just never die," I told her. 

"Sounds like a good plan but... just in case you know?" her voice trailed off. 

"Yeah I know.  I just hate talking about this stuff." I confided.

"I don't think anyone likes talking about it," my sister concluded.

I do believe my sister is right.  I don't think many people talk about this topic as it seems so emotionally daunting.  Statistics prove this to be so.  If you ask most people, they would say they would prefer to die within the comfort of their own home and with loved ones around them.  Yet according to an article by Brad Edmonson, "The Facts of Death-statistics, demographics" the statistics show that:  "Seventy-seven percent of U.S. deaths in 1992 took place in some kind of health-care facility. These include the 48 percent of U.S. residents who died as hospital inpatients and 17 percent who expired in a nursing home. Just 20 percent of U.S. residents died in a private home."

So how does one open up the dialogue with loved ones and family about your end of life preferences?

There is an organization to help you to initiate this conversation.  The organization is called Engage with Grace and their mission is straightforward:  "What if we could work together to start a viral movement - a movement focused on improving the end of life experience?  What if we took responsibility for starting a national (even global) discussion that, until now, most of us haven't had?"