For Deborah Waldrop, years of helping families cope with terminal illnesses have reinforced her commitment to her work. The professor at the University at Buffalo School of Social Work sees advance directives as more than a "check of the box" in making final arrangements. "The end of life is a time when there's still growth and change happening."
While death is inevitable, it's a subject few seem willing to consider.
"The Institute of Medicine did a report recently and they learned less than 30 percent of the population has completed an advance directive which is a written document which outlines what someone wishes to happen at the end of life."
To Waldrop's way of thinking, the numbers represent missed opportunities.
"Having a conversation. Having some completed documents (on end-of-life wishes) is a gift to those people who need to make decisions on our behalf," Waldrop said.
"It's another way of caring for someone, to say, 'Here is what I want you to know. Here's what's important for me to tell you about what I want going forward.'"
Waldrop spent 20 years as a hospital social worker before moving onto hospice. She says her work with families during end-of-life moments informed much of her research as she pursued her Ph.D.
The end of a life is both sad and profound.
"It's a time when we can still learn and make a difference in how people understand what our life was about."
While acknowledging the anxiety people feel about death and their reluctance to have end-of-life discussions, Waldrop encourages the pursuit of such conversations.
"One way to turn it around is to say, 'I'd like to tell you what I want,'" Waldrop offered as a path to starting a difficult dialogue.
"It's a two-way conversation. These are very intimate, personal conversations."