The Conversation Project

The Conversation Project

The Conversation Project


“It’s always too early, until it’s too late” to talk about advance health care planning or end of life wishes.  So… let’s talk about it!

The Conversation Project

Do you know April 16th is National Healthcare Decisions Day?  If you didn’t, don’t be surprised, the majority of folks let this day come and go each year without fanfare or even a blink of recognition. Likely as not, it’s because we’re all focused on getting past Tax Day on the 15th, and the immense relief we feel after.  Let us remember Benjamin Franklin’s famous words about certainty, memorialized famously in his letter to French scientist Jean-Baptiste Le Roy in November 1789, “…nothing is certain except death and taxes.”  Although he was referencing our shiny new Constitution of the United States, he really called it, didn’t he?

Just as we do with getting our taxes filed, we tend to procrastinate completing an Advance Healthcare Directive or talking about our end of life wishes until the very last moment, feeling certain we will know when it’s our “time,” certain we’ll get it postmarked by midnight.  But what happens when an unexpected crisis – like COVID 19 for instance, or a car accident or a stroke – sneaks up on us like a thief in the night and we run out of time to think and plan?  A major medical event happens and suddenly multiple doctors and specialists are coming at you or your family wanting quick decisions about life and death.  Do you want CPR?  Do you want a tube down your throat to help you breath?  Do you want heroic measures including major surgery, a tracheostomy (permanent opening in the throat for breathing), a colostomy, a feeding tube, or dialysis?  What if the person speaking for you doesn’t agree with the choice you want made? It is never too early to begin thinking about, writing down, or talking with your family about what you want if you are unable to speak for yourself in those situations.

Each year, Androscoggin teams up with St. Mary’s Health System to offer community outreach in celebration of National Healthcare Decisions Day.  This year brought the exciting opportunity to partner with Project Talk, a national study of advance care planning interventions in underserved communities, on Wednesday, April 12th at St. Mary’s Regional Medical Center. Hospice Foundation of America spearheads this project, funded by the National Institutes of Health, in partnership with Penn State College of Medicine and the University of Kentucky.  Androscoggin’s Kathy Amsden, Cathy Alexander and Todd McKenna teamed up with Elizabeth Keene, VP of Mission Integration at St. Mary’s to have “The Conversation” with a group of community members participating in this incredibly important topic.

Preparing ourselves for that moment when tough decisions need to be made is a gift we give to our family and ourselves; we needn’t wait for National Healthcare Decisions Day to roll around every April 16th to bring it up, in fact it’s better NOT to wait until this one day each year to think about it and take action.  There are great tools and videos at your fingertips, at the ready 24 hours a day, about how to get the ball rolling.  It’s free and easy to use; check out “The Conversation Project” website at:

Pulitzer Prize-winning writer Ellen Goodman founded the Conversation Project in 2010 with other concerned media, clergy and medical professionals after discussing their own experiences with “good deaths” and “hard deaths.”  This site is highly recommended!  It has great tool kits, activity booklets and short, humorously presented, incredibly helpful videos to help break the ice and have “The Conversation.”

According to the Centers for Disease Control, 72% of American adults agree how important it is to have an Advance Health Care Directive, yet only about 30% have completed one.  In the 60 and over age groups, less than 50% of older adults have completed a directive.    While the CDC’s research demonstrates 70% of all adult Americans will ultimately die of chronic illness, the recent COVID pandemic has highlighted how important it is to share our wishes about life-prolonging care taking into account we sometimes face unexpected circumstances.  It’s never too early to get started.

As Project Talk reminds us, “it’s always too early until it’s too late.”


By: Cathy Alexander