CHAPTER 1

Defining the Dimensions of the Other Talk

I'll never put my kids through what just happened to me with my parents!

—Several focus group participants

Do you remember how difficult—and absolutely necessary—it was when it came timeto sit with your kids to have "the Talk," the one about the birds and the bees?If you are anything like me, your initial reaction was to procrastinate, to keepthe door firmly closed on any conversations that revolved around orgasms andvaginas and penises with your kid (in my case, a 12-year-old daughter).

But why would I even consider putting off a conversation that was so critical tothe future well-being of my child? There were three reasons:

1. It was an emotionally challenging subject. It was uncomfortable andembarrassing to sit down with my daughter to explain how the body parts interactand what the physical sensations would be.

2. It acknowledged an inevitable transformation that I didn't want to face. Ifwe didn't have the Talk, I could hold on just a little longer to my fantasy thatmy little girl, my bouncy, energetic, wide-eyed, giggly preteen, would remainjust that ... forever.

3. I wanted to maintain the existing parent-child relationship. I could pretendthat our relationship would never change. We'd still read the Sunday comics onthe couch, I'd still help her with her homework, and I wouldn't have tocontemplate some boy mauling her (or, God forbid, vice versa) in the backseat ofhis car.

Because of the anticipated discomfort for me, my wife, and my daughter, I evencontemplated the sex-talk drive-by, where I would drop off the brochures on herbed with the note, "Let me know if you have any questions." As a result, I couldstay hidden behind "the birds and the bees" euphemism and avoid any realsemblance of a two-way dialogue.

Ultimately, I decided not to procrastinate anymore, and I stepped up to thatTalk—I recognized that there were potential life-altering consequences toputting it off indefinitely: unexpected pregnancy, sexual disease, andunfulfilling relationships with the opposite sex, to name a few.

Of course, that first Talk isn't just about plumbing issues, like where thingsgo, how things work, and how embryos turn into babies. It's also about thejudgments and decisions that need to be made as our children enter an importantnew phase in their lives.

Initially, the Talk was uncomfortable for all of us, but as the firstconversation unfolded and subsequent ones ensued, we began to realize that wewere empowering our daughter for something that would have far-reaching andongoing consequences for the rest of her life.

The Other Talk

There is another equally critical time in your kids' lives when you need to sitthem down to talk about the facts of life—discomfort notwithstanding. This timeit's not about the beginning of life or how babies are made. It's about the endof life—yours—and the many issues and decisions that will confront you and yourchildren.

It's the Other Talk.

Unfortunately, if you're anything like the hundreds of families and medicalpersonnel and end-of-life practitioners whom I've interviewed in preparation forthis book, you will most likely put off indefinitely any substantive discussionwith your kids about what they might expect in your last years. In fact, mostparents never have the Other Talk. The National Hospice Foundation has foundthat 75 percent of Americans don't make their end-of-life decisions known totheir families through either verbal or written communication.

Furthermore, only 55 percent of adult children have talked to their parentsabout what to do if the parents can't live independently, according to a 2009Pew Research Center survey. Some children avoid this most intimate ofconversations because they believe their parents don't want to talk about it.Others think they know what their parents want. And some simply don't want toface the very real truth that old age will most likely include disease, injury,frailty, and even loneliness and depression.

Why Do Most Americans Keep the Door Firmly Closed on the Other Talk?

It turns out that the thoughts are remarkably similar to those that stand in theway of "the birds and the bees" talk.

It's an Emotionally Challenging Subject

Sitting down with your kids to talk about your later years can be uncomfortable,painful, depressing, even paralyzing, especially when you come to the part aboutthe various stages of your deterioration, mentally and physically, and, ofcourse, that last sentence: The end.

I found that to avoid stirring up these scary emotions, many of the parents Iinterviewed for this book had taken a protective stance: I don't want to put myfamily in a state of depression and panic by talking about it.

Not surprisingly, the reality is that this "sweep it under the rug" attitudeusually has as much to do with the mental fragility of the parent as it doeswith that of the children. It seems the longer we can cling to the previousphase of our lives (the one where we are healthy, independent, and carefree),the less we need to deal with the final one.

The unfortunate consequence of protecting your kids is that, when circumstanceseventually force your family to confront reality—whether it be a serious injury,a severe financial setback, or a life-threatening diagnosis—you (but most likelyyour kids) will be reacting in crisis mode. As a consequence, your options willmost likely be dramatically restricted, and the pressure to make decisionsquickly can become overwhelming.

We Don't Want to Face the Inevitable Transformation

The last part of your life can be a joyous time. You're freed from theconstrictions and boundaries of the workaday world. You may be blessed withgrandchildren, which offers another form of liberation (for example, "Whathappens at Grandma's,...