It’s one of life’s most difficult subjects and many dance around it or don’t even talk about it at all, but Bonnie Pacuta thinks it’s time for people start openly discussing what the end of their lives will look like.

“These are the conversations that we need to start having,” says Pacuta, a social work graduate who recently launched her own care management business called Live Your Best Solutions. “Nobody wants to have this hard conversation. When you have a care manager, you know some of these conversations are going to take place. So let’s speak up. Let’s talk about these things.”

April 16 is National Advance Care Planning Day, an initiative which encourages Canadians to think and talk about their wishes for end-of-life-care. According to the initiative’s organizers, patients who have end-of-life conversations with their doctors and family members are more likely to be satisfied with their level of care, require fewer aggressive interventions at the end of life, place less strain on caregivers and are more likely to take advantage of hospice resources or die at home.

Pacuta, a member of both the National Association of Geriatric Care Managers and the Social Workers in Geriatrics Network of Windsor Essex, says planning for the last stages of life is about much more than just care options.

“A lot of people think it’s nursing, but it’s about so much more than that,” she said. “It’s getting the garbage out, getting the grass cut and the Christmas lights up. I develop a whole plan.”

A key component of a care plan is identifying a substitute decision maker. Many people will be rendered incapable of making important decisions about their care, but only 25 per cent of all Canadians have identified someone to speak on their behalf, she said.

Pacuta supports a family caregiver who recently moved her 83-year-old mother from Toronto to Windsor. Together they prepared an end of life plan for her.  In addition, she’s helping her create a more enriched life, doing everything from finding a family doctor to getting her hooked up with a bridge club.

“She just wants her Mom to be happy,” said Pacuta, who earned a BSW in 2010 and BA in public administration in 1990. “If she wants to play bridge, she’s going to play bridge. We’re going to make that happen.”

Pacuta said that client’s situation is typical of many Canadians with aging parents.

“The average family caregiver today is at the height of their career and may have children of their own at home,” she said. “The thing about it is that we don’t really get a chance to get good at caregiving. Some family caregivers just need an empathetic ear to talk to.”

Pacuta said her return to school as an adult wasn’t easy – she has three children and all of them were studying here at the same time as her – but it paid enormous dividends. She credits the social work program with improving her critical thinking skills and professors like Thecla Damianakis and Don Leslie with giving her the courage to launch her initiative.

“I think my return to school really heightened my research skills,” she said. “A lot of that is all about going to journals, seeking out best practices and evaluating programs for effectiveness. For the first time in my life, everything that I’ve learned is now required.”