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Silver Linings: 'Dying to Talk' series focuses on having the tough conversations

New Hampshire Union Leader

June 25. 2018 10:56PM
Hospice Care Services Manager Leanne Tigert poses at the Hospice House at Concord Hospital on Thursday. (DAVID LANE/UNION LEADER)

Death conjures visions of caskets and funeral homes. But it also means family gatherings, meaningful moments, frank conversations and advance planning.

Leanne Tigert, a spiritual care counselor and hospice care coordinator with Concord Visiting Nurses, hopes the agency’s series, “Dying to Talk,” will spark community interest, sincere discussion and sharing of experiences, hopes and beliefs.

“Ceremonies, Ritual, and Burial” will be held Tuesday July 17, 2-3 p.m. at the Epsom Public Library; “What Matters Most” will follow Sunday Sept. 9, 2-3 p.m. at Main Street BookEnds in Warner. The sessions are free.

Tigert says they will include “All those taboo topics we have a hard time talking about.”

What do I want to have done with my body? How do I want to be remembered in life? What kind of service to I want? A life celebration or a formal funeral? Do I want to be cremated or buried? Do I want CPR in the hospital or do I want comfort measures at home? Who do I want or not want with me when I die? How much pain can I tolerate — and what do I want done to alleviate my pain? What am I most afraid of? What do I think happens when someone dies?

“The biggest misconception I hear is that people believe their family members aren’t able to have this conversation,” Tigert says. “As a rule, people don’t need to be protected from this information.”

The importance of having frank conversations and written end-of-life instructions cannot be overstated, health care and legal experts say, as baby boomers, who account for the bulk of the world’s population, continue to age.

Rev. Rosemary Lloyd, former pastor at First Church in Boston, now spiritual counselor for The Conversation Project, a nationwide movement to encourage family conversations about end-of-life wishes, says “It’s not going to make it any less sad (when you die), but it will make it less complicated and lessen their remorse and guilt. People will have understood each other about what matters most. Don’t just talk to your favorite daughter. Talk to your spouse, all your kids, and your best friend so you don’t have fights at your bedside.”

The Conversation Project’s website offers a free, downloadable “Starter Kit” to help people talk to loved ones.

In New Hampshire the number of deaths, and residents needing end-of-life care, is expected to rise steadily until 2057, according to state demographic and health care projections. Between 2005 and 2016 alone, the United States experienced a 46-percent increase in the number of people utilizing hospice care, according to Hospice Analytics, a company that analyzes state and national Medicare data. During that time, the number of Granite Staters receiving hospice care increased by more than 50 percent. According to a 2013 survey cited by The Conversation Project, 80 percent of people who are seriously ill want to talk to their doctors about end-of-life options, but only 7 percent have actually done it.

New Hampshire communities are embracing new ways to reach out to seniors. Town officials and health care workers in Lyme and Cornish are offering in-home meetings, small discussion groups, opportunities for seniors to make new connections, and kits and checklists to help older residents navigate the end of life planning process.

“Dying to Talk” is patterned after Death Cafes, an international movement started in England in 2011, in which people gather to discuss death and dying and end-of-life wishes over tea and cake.

Tigert says “Dying to Talk is about making it OK to have these conversations,” and preparing seniors and those with terminal illness to speak to their loved ones about interventions such as CPR, feeding tubes, and pain medication.

“There are more options beside ending up in the ICU on tubes and a ventilator with loss of control, or going to Vermont for physician-assisted death,” Tigert says. “In the hospice house, we’ve had weddings and birthday parties, and organized trips to the ocean for some people. The conversation is polarized, but there’s a whole array of care options and experiences available, but not if they don’t want to talk about it.”

Silver Linings is a continuing Union Leader/Sunday News report focusing on the issues of New Hampshire’s aging population and seeking out solutions. Union Leader reporter Roberta Baker would like to hear from readers about issues related to aging. She can be reached at or 206-1514. See more at This series is funded through a grant from the Endowment for Health.