How Humor Helps with End-of-Life Planning

Dr. Christian Seiter began his career and academic journey with a love of sketch comedy and aspirations of becoming a Saturday Night Live writer. After working in hospice care, his career shifted toward end-of-life communication and advance care planning. Now a professor at California State University, he has combined his interests in the Death Positive movement with his early acting and comedy training to explore how planning messages might be received with an injection of humor or even profanity.

Podcasts Test Acceptance of Humor in Planning

Seiter said his initial research used three podcasts played to over 600 participants: one that was focused on planning without humor, another that added humor, and a third that injected some profanity. Not unlike an SNL sketch, they each illustrated a scene in which a family grappled with the lack of planning of a loved one at the end of life. 

Those tested only heard one of the podcasts, so they did not choose between them but did share their opinions about what they heard. Seiter says there’s more to be explored but he and his colleague discovered that the non-humorous was the most effective in terms of perceived source credibility, effectiveness, etc. But that, “for the people that the humor didn’t offend, the humor version worked great.” He’s still optimistic that humor can be an effective way to communicate with those people who are open to it.

Though he hasn’t explored the data fully about the message’s effectiveness by age, anecdotally, his research seemed to show that Millennials were more comfortable with humor than their older counterparts.

Humor Makes Challenging Topics Approachable

Seiter plans to continue to explore the power of humor more because he believes it offers opportunities to open important planning conversations. He says other studies have shown the positive impact of humor. “Humor has been shown to make these challenging topics really approachable,” he explained. 

Seiter has some tips for getting a planning conversation going. For example, “If it is too scary to have a conversation with your mom, simulate it with a friend,” he suggests, crediting the nonprofit Conversation Project for their work which he has evaluated in another study. 

Advice for End-of-Life Planning Conversations

Seiter also says he likes to break the advanced care planning process into three separate segments. The first is “values clarification.” “Why talk about someone else’s plans if you don’t know yourself?” he says, explaining that it requires some soul-searching and research for that “intra-personal” communication.

Second, Seiter says the next phase is sharing the plans with another person in interpersonal communication, where you share your wishes and perhaps hear theirs. Third, he says, is the paperwork like advance care directives, which can be intimidating, so he recommends not starting there but instead leaving that for last.

For that initial conversation, Seiter says it doesn’t need to be this “super heavy thing.” “Try bringing it up in a casual way and see what happens,” he suggests.

Another analogy he shares with his health communication students is this: “Advance care planning and advance directives are like a toilet plunger. If you need it, and you don’t own it, it’s too late,” he said laughing. 

Dr. Seiter’s research concerns communication in the end-of-life context. Specifically, his mixed-methods work examines the use of novel communication strategies (e.g., humor, worry) to motivate discussion of end-of-life wishes within families. Dr. Seiter also studies spiritual communication and social support in health contexts. Before his Ph.D., Dr. Seiter received an undergraduate degree in acting. Now, he uses his theater background to develop and evaluate communication workshops for healthcare providers. His scholarly work can be found in journals such as Death Studies, Health Communication, and The Journal of Health Communication.