This week discussing death over dinner got a whole lot easier with the launch of an interactive website that provides a draft invitation, preparation material for guests and conversation ice-breakers for hosts.

Death Over Dinner has inspired more than half a million people in the US to sit down to a meal and discuss end of life since its launch there three years ago.

The new Australian version, launched by the Australian Centre for Health Research (ACHR), has been tailored for a local audience and achieved a wide range of ambassadors, ranging from medical experts to authors, policy makers and artists.

Visiting Australia for the launch during National Palliative Care Week (22-28 May), its US co-founder, Michael Hebb, said Death Over Dinner had helped to shift policy and funding for advance care conversations in the US, and driven uptake of advance care planning.

Mr Hebb said the first Australian Death Over Dinner event was an auspicious occasion in a private dining room at the Melbourne Mayor’s office, where the conversation could have flowed for three days.

“I was blown away by the level of leader we had at that dinner and their enthusiasm; people like Professor Fiona Stanley [former Australian of the Year], Lyn Swinburne [founder Breast Cancer Network Australia], the Honourable Mary Wooldridge [Victorian Shadow Minister for Health] and Dr Stephen Parnis [AMA vice president].

Mr Hebb said when Death Over Dinner was launched in the US, it took people by surprise and was considered a controversial, maverick concept.

“In the US most of the end-of-life-conversation tends to be euphemised and the medical establishment doesn’t talk about death,” Mr Hebb said.

“It is significant to see the immediate response from leaders in Australia. It really says Australia wants to change the way we handle end-of-life care and not just give it lip service.”

How it works

The Death Over Dinner site asks hosts to answer basic questions about guests and why they are having the dinner.

It then prepares materials for guests to read, listen to or watch in advance, which hosts select from an extensive library.

Hosts receive an email with a draft invitation and support materials, including hosting tips and ice breakers to get the conversation started.

The dinner party host then chooses their guests and the menu, and lets the wine and conversations flow.

Mr Hebb said a high percentage of people who attend a Death Over Dinner event spend 30 minutes absorbing the background material before they arrive. Compiled with input from ACHR and ambassadors, that homework improved the depth of conversation that ensued.

He said there tends to be tears and laughter at dinners in equal amounts, but dinners don’t have a history of going horribly wrong because questions are kept open-ended.

“They are not questions that are going to create arguments. They are questions that allow people to talk about their personal experience, as it relates to death,” Mr Hebb told Palliative Matters.

“People generally don’t interrupt, argue or look at their phone. There is a basic human reverence it taps into.”

He said if people are not ready to have the conversation, they tend not to come, but the process of simply inviting someone may “start some healing”.

“We hope those who RSVP to a Death Over Dinner will celebrate life while talking about death,” Mr Hebb said.

“We know conversation can make all the difference, and good food and wine can make any topic more palatable.”

The difference a dinner can make

Mr Hebb said more than 100,000 dinners had been hosted in the US and he had hosted and attended about fifty. He had had memorable feedback from one high-profile host, who invited his friends to dinner.

“He had a very troubled relationship with his parents and after Death Over Dinner he realised he needed to have a conversation with his father about his father’s wishes," Mr Hebb said.

"His father was struggling away in a town several hundred miles away and they hadn’t spoken for about 10 years.

“A tremendous amount of healing has happened between the host and his father. His father and mother ended up in separate nursing homes, which needed to happen, but wouldn’t have happened without the conversation.

“These kinds of stories are happening all of the time, because Death Over Dinner gives people permission to talk about things we avoid. It can be transformative at that moment, but it also increases death literacy, which leads to changes in care plans and end-of- life trajectories.”

A new take on being a burden

Death Over Dinner has also affected Mr Hebb’s personal philosophies about death and dying. He said he had learned something from every dinner, but one question in particular had a big impact.

“I had this notion in my head that when I died I wanted to head out into the woods and be a lone wolf,” he said.

“It was because my father died of Alzheimer’s and watching all the care and disaster of his last years left me thinking I didn’t want to be a burden.”

That changed when, over dinner, Mr Hebb was asked what his final days would look like. He realised all he wanted was to be surrounded by his daughters, and the notion of being a burden had healed.

“It is a beautiful thing to be needed and to need other people. I realised that if I had parented from the perspective of not wanting to be a burden, then what was I teaching my children. It rocked me pretty hard.”

So, let’s get started

ACHR executive director Rebecca Bartel said talking about death is about planning for life. She called on all Australians to fill their table with food, family and friends, toast to life, honour loved ones who have died and ensure everyone’s wishes for end-of-life care are expressed and respected with understanding and compassion.

“Conversations about end-of-life care often take place at a hospital in the midst of a crisis,” Ms Bartel said.

“Decisions have to be made quickly and under stress. This means many people die in a way they wouldn’t choose. Loved ones are left feeling guilty, bereaved and anxious.

“We invite Australia to have this conversation at the dinner table with their loved ones, not in the intensive care unit after an emergency when it is too late.

“We believe that conversations about end-of-life care shouldn’t start with doctors in intensive care units when people are overwhelmed. They should start with family and friends while breaking bread.”