In the middle of Downtown Summerlin you’ll find the “Before I Die” wall. It’s black and covered in white stenciled sentences that say, “Before I die, I want to …” People approach the wall, pick from a bucket of colorful chalk, and fill in the blanks: “ ... watch my girls grow into caring successful adults,” for example, or “... heal my relationship with my mother.” 

There’s a subtle calm this afternoon. The kind you get from contemplating your own life and the things that matter. I reflect on my 60-year-old parents, who emotionally withdraw every time I use the word “death.” I recall my grandma, who passed away too soon for me to say my final goodbye. I consider all the things I’d want to do before I die. I begin to think about death in a new light.

The Before I Die wall was brought here by the Nathan Adelson Hospice in honor of November’s National Hospice and Palliative Care Month. It was created by artist Candy Chang on an abandoned house in New Orleans after someone she loved passed away. It encouraged people to deeply reflect on life, death, and how to spend the rest of their time. Since then, more than 5,000 walls have cropped up in 78 countries and in 35 languages. (For more, listen to this conversation about end-of-life issues from KNPR's "State of Nevada.")

The majority of people would prefer to pass away at home, yet most die at a hospital, according to figures from the Stanford School of Medicine. But some centers in the community are committed to changing that. 

The Nathan Adelson Hospice provides inpatient and home-based care and never turns anyone away because of an inability to pay. In 2018, the hospice cared for 4,183 patients, of whom 1,157 were uninsured or underinsured.

“If someone can’t pay for hospice care, it doesn’t matter, we’ll find a way to make it possible,” says Caleen Norrod Johnson, executive director. “We don’t want anyone to face the end of life afraid, alone, or in pain.”

When a person faces the end of life, it can put an emotional and financial strain on the family. When insurers can’t cover all hospice-care costs, NAH will sometimes help the patient’s family with any financial strains (rent, mortgage, utility bills, grocery expenses, etc.) through its Families in Need program.

“Hospice is not a place, it’s a concept, it’s a way of thinking about the end of life and giving dignity and grace to someone’s ending,” Johnson says. “To have the final chapter of their story be something that’s peaceful.”

A few days after seeing the Before I Die wall, I attend an Alzheimer’s themed edition of Death Over Dinner, a project that invites people to transform difficult conversations about death into something insightful, powerful, and engaging — over a nice meal. It was founded in 2013, and the organization says more than 100,000 death dinners have taken place all over the world. This one is hosted by Cleveland Clinic Lou Ruvo Center for Brain Health, which provides diagnosis and treatment for patients with neurological disorders and support services for the patients’ loved ones. More than 5,000 people are currently in care. 

At the outset, Death Over Dinner founder Michael Hebb announces the rules of the night. “If this is a board game, what wins is vulnerability,” he says. Surrounded by six others at a round table, each person answers a series of questions about end-of-life plans and wishes. For example: What are your wishes for your body after you die? Do you want to be cremated, buried, a green burial, turned into a coral reef or a diamond?

“I’d want to do a green burial,” says Evelyn Marie Sabina. “It’s like that quote, ‘For you were made from dust, and to dust you will return.’ I kinda see it that way. I want to leave the world like that. I just want to be a part of it.” 

As the dinner ends, we thank one another for sharing personal stories. “It’s an individual's responsibility to have these necessary conversations, to ease the pressure off their family members,” Sabina says. “A reminder of death forces you to be more present with your life.” 

I’ve come to see death as an inevitable reality, a thing to accept, embrace, and thoughtfully plan for. As for death conversations, of course, there isn’t a step-by-step guide to something so complex. But with a sliver of courage, vulnerability, and acceptance of mortality, perhaps we can make death no longer a word to fear but a conversation to embrace.

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