GOLDEN VALLEY, Minn. - Death and end-of-life care are not often popular topics of conversation around the holidays, but it is often the best time to explore wishes with loved ones.

Honoring Choices Minnesota and The Bruce Kramer Collaborative are working with KARE 11 to try to get the end-of-life conversation started in more homes this holiday season, and one local family learned why it's not difficult to start talking about a difficult topic. All it took was a little education and an open mind.

Jackie Paule talks end-of-life planning with her grandfather, Roger Gustafson, over Thanksgiving.
Jackie Paule talks end-of-life planning with her grandfather, Roger Gustafson, over Thanksgiving.

Jackie Paule is a teenager who agreed to sit down with her grandfather, Roger Gustafson, to discuss advanced care planning during their family Thanksgiving.

Jackie: "Have you thought about it before?"

Roger: "Have I thought about what?"

Jackie: "What you want when you die?"

Roger: "If I'm not mentally able to make decisions, we have to start worrying about power of attorney but also doing a health care directive."

Jackie: "It sounds like you kind of already know what you want for your end of life."

Roger: "I'd like to go like my Dad did. He went out for a walk, came home, laid down and died."

The conversation stemmed from a lesson that started in Jackie's Biomedical Science class at Benilde-St. Margaret's High School. The teacher of that class, Kirsten Hoogenakker, decided to create a unit that focuses on palliative care and advanced health care directives.

"Sometimes you want to continue treatment," Hoogenakker said. "Sometimes you don't want to continue treatment."

The topic of end-of-life care is close to Kirsten's heart because of her own experience.

Jackie Paule, and her mother Michelle Paule, discuss end-of-life options during class.
Jackie Paule, and her mother Michelle Paule, discuss end-of-life options during class.

"My mom was diagnosed with cancer when I was a senior in high school," Kirsten said.

Kirsten's mother died after several years of fighting, but she says questions still linger about her mother's wishes.

"I don't think she had a care directive, at least as far as I know," Kirsten said. "I really question whether or not those last six months of her life were really what she wanted."

Kirsten says her father-in-law, Bruce Kramer, was diagnosed with ALS just prior to her mother's death, but he left no questions about his wishes.

"How powerful it was, that he knew exactly how he wanted to die and what that entire process was going to look like," Kirsten said.

Her class is now helping break down that process. She invited parents to her class to talk about and write down their wishes together. Some of her 18-year-old students even notarized their own health care directives.

That's when Jackie Paule, and her mother Michelle Paule, realized the importance of taking the conversation home.

The topic of end-of-life care is close to Kirsten Hoogenakker's heart. She lost her mother to cancer.
The topic of end-of-life care is close to Kirsten Hoogenakker's heart. She lost her mother to cancer.

"I keep on arguing with my dad to have it done so I think this exercise with you and I will help open the conversation," Michelle Paule said. "And get him to start talking about it."

"I'm going to have it done by January 1st," Roger Gustafson said. "I already started."

It turns out Roger knows how important that promise can be.

"After my father died, my mother didn't care to live," he said. "So she just kind of let herself go because she wanted to (die)."

Roger says his mother's choice to die instead of seeking treatment, might have been ignored if not for a conversation about end-of-life.

"They weren't honoring her, so there were five kids and all five of us went there and talked to the doctor," Roger said. "It's the only time they allowed her to pass away the way she wanted to."

Roger says that is why he is happy to have a conversation with his family about his own wishes.

"This is very important," he said. "And it has to be followed."

Honoring Choices Minnesota has many different resources for getting the conversation started at your own holiday gatherings, including healthcare directive forms that you can download and print in several languages.

The Benilde-St. Margaret's class also used a card game called Go Wish in order to get the conversation started.