One City Talks about Death

A Program in LaCrosse, WI, Facilitates Family Conversations

November 16, 2014
Photo courtesy of Gundersen Health

It's not uncommon to hear people plan out their last days in La Crosse, WI. More than 90 percent of the people who die there have an advance directive or similar plan for end-of-life care – that’s three times higher than the national average.

Bud Hammes is a medical ethicist who’s credited with getting the town to talk about death. More than 20 years ago, he founded Gundersen Health’s “Respecting Choices” advanced care planning program, which brings families together to have honest conversations about end-of-life care.

“I hear again and again people won’t talk about this,” Hammes says. “I think the trouble is --  in any of our families when we talk about important issues – we fear conflict [and] disagreement.”

“Respecting Choices” conversations usually follow a similar pattern: a facilitator brings together family members and asks a series of open-ended questions, but really they’re just there to listen. These conversations usually focus on a patient’s beliefs, fears, and final wishes.

“When at least these conversations are done well, I think not only is it a positive experience for the family, but what they’re in fact saying at the end is that they love each other.”