Difficult Conversations

As a nurse who worked in Emergency and Critical Care areas, I witnessed families arriving in shock and disbelief that their loved one was in critical condition after a tragic accident. A previously healthy individual was now facing the very real possibility of death. In these situations, every life-saving technology would be used to return that person to their prior quality of life. Heroic efforts would be made on their behalf until it was determined that sustaining life would not be possible.

As tragic and difficult as those situations were to witness, there was another sad and commonly occurring scenario. That’s when an elderly patient arrived in the ER or ICU unable to tell us what their wishes for care were. Unfortunately, in many instances, their loved ones had no idea what the patient would have wanted, because death is too difficult to discuss. So they simply didn’t have a conversation about what they’d want. As a consequence, family members had much remorse about decisions they were unprepared to make.

There are few certainties in this world, but these two are absolute: birth and death.

Consider the upcoming birth of a new baby. Most people plan well in advance for that significant life event. Death is equally significant. The difference is that the details of the death aren’t as predictable as those of birth.

When I had the privilege of being with a family at this difficult crossroad, I provided empathy and support. I translated their physician’s medicalese, I fielded their questions, while guiding them to conversations that proved beneficial in light of the unknown. Asking, “Tell me more about your dad” or “Has your mom talked about someone she’d known in this situation?” These questions revealed what they may have wanted for care at that moment. However, the tearful eyes of spouses, daughters, and sons often reflected the heart-wrenching dilemma they were undergoing.

The pain of losing someone you love is compounded if you have no idea what they would find acceptable or not. For this reason, I encourage YOU to have a conversation with your parents or elderly loved ones.

There are many resources to help determine what is acceptable, and what is not acceptable to us if/when that situation presents itself. Each of us will likely have differing desires. That’s expected, and perfectly fine.

One resource I highly recommend is The Conversation Project. This is from their website:

The Conversation Project® is a public engagement initiative with a goal that is both simple and transformative: to help everyone talk about their wishes for care through the end of life, so those wishes can be understood and respected. Too many people die in a manner they would not choose, and too many of those that cared for them are left feeling bereaved, guilty, and uncertain.

It’s time to transform our culture so we shift from not talking about dying to talking about it. It’s time to share the way we want to live at the end of our lives.

And it’s time to communicate about the kind of care we want and don’t want for ourselves. We believe that the place for this to begin is at the kitchen table — not in the intensive care unit — with the people who matter most to us before it’s too late. Together we can make these difficult conversations easier. We can make sure that our own wishes, and those of the people who matter most to us (our loved ones, friends, chosen family), are both understood and respected. The Conversation Project offers tools, guidance, and resources to begin talking with those who matter most about your and their wishes.

Speaking to your loved ones also provides the opportunity to consider your own choices. However, if you get clammy with the prospect of talking about the end of life, using a facilitator to guide you through the process can be the key to getting started.

Have that conversation.


Mariah Edgington
Mariah Edgington
Mariah Edgington BSN, RN: Retired Critical Care/ER/Flight Nurse. Published Author. Professional Speaker. Contributor: BizCatalyst 360° and Medium Digest. Content Creator. After gaining the insight that she is Neurodivergent, with ADHD & Dyslexia, Mariah now mentors other neurodivergents giving them tools, tips, and techniques to live to their fullest potential. She wants everyone to know that their lives are of value, and they are More Than Enough. That there’s a better brighter life calling and encouraging everyone to capture that life. Mariah co-authored, Journey Well, You Are More Than Enough, (RE)Discover Your Passion, Purpose, & Love of Yourself & Life with her husband, Byron. The book is available on her website, along with the accompanying Guidebook, Online Course, and Gratitude Journal. See Mariah's social media channels above. Website:

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  1. A pandemic may have been a “good opportunity” to get advance directives in order. I know I have worked on mine.

    Talking to my mother the other day, I asked which psalms she liked. Oh, you can chose whatever you like, she said. I reminded her how much grief she had been in when my father died and said that selecting something would be a kindness to those left behind because, truly, so many things need to be done and everything already planned is a help in a stressful time.
    That proved a good and relatable argument.

  2. Mariah
    Thank you for this sensitive and inspired article. It is constructed with great thought and “empathy” something you obviously have been blessed with. As a volunteer emergency responder for the ambulance service and a former serving police officer, the scenes you described resonate with me strongly. Whilst we did not get involved quite like you did, I have witnessed the grief and confusion amongst loved ones. Nurses like you never cease to amaze me, I am truly in awe of their ability to hold everything together and be of the ultimate value at such a horrendous time. Your advice in this article is so useful.