Most Americans fear death — but that wasn’t always the case.

In the Victorian era, Americans embraced death like a close friend. That’s because during that time, death was much more commonplace. Infants sometimes were not named until after their first birthday because of how high the infant mortality rate was at the time, and mourning was often a very involved affair.

Much of the death during this time was caused by poor working and living conditions, as well as high volumes of disease without any effective medical treatment. Since then, medicine has changed much of that.

There have been many medical advances since the Victorian era. According to Lawrence R. Samuel, Ph.D., an American psychologist with expertise in death and dying, the American culture focuses on science and medicine as a solution to the “problem” of dying.

This sort of mindset — that dying is a problem, not a natural occurrence and regular part of life — influences much of the American fear of death and our reluctance to talk about it openly. A CNN article recently interviewed Kate Sweeney, author of American Afterlife, about this very topic. She had this to say:

“Americans … are so obsessed with youth and triumphing over every challenge they face that they become afraid of aging and death, often seen as life’s ultimate defeat.”

But the culture in America is beginning to shift, especially since we are at the very beginning of the death of America’s largest generation, the Baby Boomers, according to the U.S. Census.

Shows like Six Feet Under on HBO and Time of Death on Showtime and the rise of social events like Death Cafes is making death a less taboo topic in America. And that’s a good thing, too, because many people who are afraid to talk about death often wait until it is too late to discuss with their loved ones what they want when their time comes, like:

• What do you want to happen with your belongings?
• If you have children that are not yet adults, who will care for them?
• If you are ill or incapacitated, what measures do you want or not want medically?
• Do you want to be an organ donor?
• Do you want a burial? Where?
• Do you want to be cremated? What should be done with your ashes?

These are just a few of the things that are hard to talk about, but very necessary if you want to be sure that everything is taken care of according to your wishes when your time comes. And if you plan on having a funeral, you can even preplan and slowly pay for those services rather than surprising your family with a $7,000 expense when you die.

Have you had these conversations with your family? Don’t let your fear of death or discomfort with the topic get in the way if you haven’t — life is short, and it’s never too early to start planning your end-of-life care and preferences.

Has your family discussed your end-of-life wishes? Share your tips on how to start the conversation in the comments below!