Our passage from Luke’s Gospel this morning reminds us of the call to be in right relationship with God and one another. Throughout scripture, we are reminded again and again of the covenantal relationship that God has offered. Living in relationship is at the heart of being human. Jesus calls his followers into relationship and models what it means to love God and our neighbor. Relationships can be amazing and beautiful; they can also be messy and complicated. But we know that we are born into relationships, loved from before we were born and we will always be connected to God and to others throughout our lives. Last spring, I attended the annual Hospice of Southern Maine Conference in Portland where I heard a number of wonderful speakers. The keynote was done by the writer and journalist, Ellen Goodman, who has a summer home off of Portland and was a columnist for the Boston Globe for many years. Perhaps some of you remember her writing? She spoke about this important project she helped found years ago after waiting too long to have important conversations with her own mother about her wishes for care before she died. She realized the great need for many people to have support and guidance in undertaking conversations about their wishes for living well as they neared the end and thus, the Conversations Project was begun. As Ellen Goodman says, “It’s always too soon to start the conversation…until it’s too late.” Essentially, the Conversations Project provides wonderful resources and opportunities for people to consider their wishes for end of life and to prepare for conversations with trusted family and friends long before the need arises. A favorite passage from Paul’s letter to the Philippian community reminds us that our God is a faithful God who is with us always. He writes, “Be anxious for nothing, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” Whether this topic causes you anxiety or brings you a measure of calm, we know that our God loves us and is walking with us always. Let us pray, O God, you have given us life to live abundantly and one day, you will welcome us home into your love and peace. Guide us as we consider the precious lives you have given to us, enable us to be thoughtful as we consider what matters most for us to live well and to die well. We thank you for this gift. Amen.
The author of a wonderful book called Being Mortal, Atul Gawande, has said, “Our ultimate goal, after all, is not a good death but a good life to the very end.”
I imagine that most of us have at some point in our lives, accompanied a friend or family member in their final years and days of life. Like so many important things in life, this journey can be beautiful and complicated and messy and sacred. When families know what their loved ones want, the process is often far less complicated as they have guidance in how to best journey together. I have witnessed the great need for such conversations firsthand in my work as a hospital chaplain years ago, in my ministry as a church pastor, and in my own family. I know how important this is. For some, it is a difficult conversation to have. I have heard couples tell me that one or the other just doesn’t want to discuss it until sometime down the road. For others, and I know a number of folks in this church, there is great comfort in considering and planning for these things. None of us knows how our lives will unfold, but experience tells us that it doesn’t often happen as we imagine it will.
Nearly 15 years ago on my birthday, my father suffered a terrible stroke and was rushed to the hospital. He had suffered a brain bleed and the doctors sat with my family in the ICU waiting room at Maine Med and spoke to us about options. They tried one procedure to try to stop the bleeding, however, it was unsuccessful and now they were asking for our input again. My mother wanted us to make a decision together, which might not have been easy with a large family; however, when they asked us if we knew what our father would have wanted, we said absolutely. We know because he told us on more than one occasion. He always said to not use extraordinary measures. He had completed his advanced directive years before. He often said, “if I go quickly, be happy for me.” And so, as painful as it was, within days, we sat with him as they removed the tubes and we said goodbye to him. Was it heartbreaking, yes? Did we feel a great sense of peace in having followed his wishes? Absolutely. He had seen his own mother languish for months following a stroke and he never wanted that for himself, nor did our mother. She was a huge supporter of hospice and thankfully, she too had her advanced directive completed years before she neared the end but thankfully, she was able to speak for herself in her final days and express her wish to go to Gosnell House. Again, we felt great sorrow with her loss of sorrow, and at the same time, gratitude and peace in knowing we followed her wishes as best we could.
This time of year, as the seasons change, we see the circle of life unfolding in the beauty of nature. We have had incredibly beautiful days of autumn as we watch the leaves turn color and the colors in our gardens dim. We feel the hints of frost in the morning as we watch the land ready itself for winter. We look ahead to Halloween and All Saints Day, a time for remember those we have loved and lost, all of these rituals reminding us of the seasons of life. It can be a time of melancholy as our daylight hours shorten and we too are reminded of our own mortality. For us as a community of faith, our connections to one another and to our God may bring us comfort as the days unfold. We may feel fear or uncertainty about what lies ahead and yet, if we remember we are held in love, we may know peace and gratitude for what has been and what may come.
And so this morning, I wonder…Have you had the conversation with your family or friends? Do you have your advanced directive completed and witnessed? Perhaps thinking about the last days is easier than thinking about the final months or years but that is also where a lot of important decisions about how much medical intervention you want and what will allow you to have as many good days as possible can be made so that those who love you may be guided by what you most want. We don’t know what physical limitations or challenges we may face, but I know that it is empowering to have a say in the decisions that will govern our care and dictate the quality of our days.
Sixty percent of people say that making sure their family is
not burdened by tough decisions as they die is “extremely
important” but 56% of these people have not talked with their
loved one about their end-of-life decisions. Eighty two percent of
people say it’s important to put their wishes in writing; twenty
three percent have actually done it. Seventy percent of people way they
want to die at home but seventy percent will actually die in a hospital
or nursing home. Did they tell anyone what they wanted?
I know too that a real concern in this for many is the cost of healthcare, especially for the types of care that are sometimes required in the final years. We may not be able to control all of these decisions because much is unknown; however, being clear in advance about what you do and do not want to pursue in terms of endless tests, medical intervention or appointments, is vital. In her final years, my mother would tell us that she didn’t want to spend her time going to the doctor; she didn’t want or need to have another colonoscopy. She wanted her days to be spent in ways that were comfortable for her, spending time with her family and not sitting in a doctor’s office. That was her choice.
The Conversation Project is not about having one conversation. At different points in your life you will want to renew the conversation. What I want now is different from what I would have wanted when our kids were young. What I imagine I would want now is different from what I may want at age 90.
We don’t like to think or talk about death, but we know that death if very much a part of the cycle of life. For many people, thinking about their future death helps them live with greater meaning and joy. When we face our deaths, then we can truly live. Talking about life and death is at the heart of what it means to be human. We know we live in a culture that is uneasy about death; however as we consider our lives and what brings us meaning and hope, reminders of our mortality may shape our living in so many important ways.
At the same hospice conference last spring, the afternoon speaker Joe Primo shared some thoughts that have continued to echo in my mind since that time. As he talked about his work with families, he counseled us to not leave a mess behind. He meant this both in terms of our material possessions but also and much more importantly in terms of our relationships. Being in right relationship with those we love makes the final days so much less complicated. Leaving guidance about our wishes and planning as best we can makes it far easier for those we leave behind. He writes, “There are a few things about death we can control; our emotions are not among them, though we can control our story and how we share it with others. Death is not a choice, but much of what happens around end-of-life care is about options. We can receive countless expensive treatments for a terminal illness because we want to fight to live. But we also have the choice to surrender. And as our days wind down, we can make choices about what happens at the end and after we die.”
This has been a year of loss within this beautiful church community as we have said goodbye to a number of special friends. They each contributed something beautiful and important to the world and we give thanks for their lives and for the lives of those in our own families and circles of friends who have left us over the years. May we take comfort in knowing that we walk together in faith and that our God has been with us always and will be with us until the end of time.