Dale Larson, PhD
Biography

	How should we initiate an end-of-life conversation with family? Should you talk with your doctor first about end-of-life decisions? How can an advance directive help a family talk about the issues? What kinds of conversations should we have toward end of life? Can hospice help me talk with my family?

Whether you are making decisions about your own care or need to know the wishes of a family member, straight talk is vital. Dale Larson is a professor in the department of counseling psychology at Santa Clara University and is the author of The Helper's Journey: Working With People Facing Grief, Loss, and Life-Threatening Illness. He joined us September 28, 2005, to offer advice about having an open dialogue with your family.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

This WebMD University course is brought to you by VistaCare.

MODERATOR:
Welcome to WebMD University: "Planning Ahead." Your instructor today is Dale Larson, PhD.

Welcome, Dr. Larson. Why do we have such a hard time discussing the end of life -- our own or our loved ones?

LARSON:
That's a great question and it gets right to the core of what we're going to talk about today.

We all remember what Woody Allen said: "I'm not afraid of death. I just don't want to be there when it happens."

Sigmund Freud said, "The ego cannot imagine its own dissolution." Once in a lighter moment he said to his wife, "If one of us two dies before the other, I think I'll move to Paris."

Ernest Becker, in his Pulitzer Prize-winning book, The Denial of Death, argued that death, anxiety and our attempts to deny it underpin much of human psychology. Finally, Kubler-Ross said that death was the greatest and last taboo.

So, approaching this topic is never easy, whether we're the person who's suffering from a life-limiting illness or we're a family member trying to find a way to talk about this very difficult subject. It really forces us to come to terms with some experiences that are very close to us and are tough to wrestle with.

MODERATOR:
We have had very public examples of what can happen when we don't discuss our wishes for the end of life. It sparked much public debate, but do you think it motivated people to have the very personal discussions about our own wishes for end of life?

LARSON:
I think that some of the recent issues, like those concerning Terry Schiavo, and the recent hurricane disasters, have really taught us that it is important for us to plan in advance because sometimes we don't have that opportunity.

"We very often hear 'Iwish we had known what my loved one really wanted.'"

One of the things we hear from families, for example, is "Why didn't I hear about hospice earlier?" And we very often hear "I wish we had known what my loved one really wanted, we just didn't know when we had to make those very difficult decisions."

I do think we have a national conversation occurring about some of the issues involved and that is a good thing but it's also true that we have to, as individuals, begin to have these kinds of conversations more frequently with our loved ones before life-threatening illness or catastrophes occur. We have to talk about it when we're healthy.

One of the findings is that people appointed as proxies by individuals and their family have no more idea of what a person would want in a specific situation than someone chosen randomly. This might be a surprise for most people, but it suggests we really need to let our loved ones know what we would like to have done if we're unable to express our wishes.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician.