Our government has just brought in new laws about the right to die, which in its attempt to be all things to all people, of course means all sides of the issue are upset. End of life is a contentious issue in Canada.
Two
new studies have shown that Canadians are not prepared for the end of life. A
national study of elderly, ill Canadians and their caregivers, as well as the
results of a national Ipsos-Reid poll indicate that most Canadians have not
talked to their family or their doctors about their preferences for care should
they be unable to speak for themselves.
That’s
why over 25 associations across Canada have joined together to champion April
16th as a day for Canadians to speak with family members and friends about
their wishes for end-of-life care.
Advance
Care Planning is a process of reflection and communication about personal care
preferences in the event that you become incapable of consenting to or refusing
treatment or other care. The most important aspects of advance care planning
are choosing one or more Substitute Decision Makers – someone who will speak on
your behalf and make decisions for you when you are not able to do so yourself
and having a conversation with them about your wishes.
Research
results released today from the ACCEPT study,
a multi-year national study of elderly, sick patients and their caregivers
indicate that more discussions are needed both between family members and with
doctors.
One
would think that the patients in our study, most with about six months to live,
would be more engaged in advance care planning. But only about 20% had been
informed by their doctors about their prognosis, and 44% weren’t actually sure
what the goals were for their current treatment, says Dr. Daren Heyland, the
Principal Investigator of the study.
A
number of study participants, despite their condition, had not created an
advance care plan as they felt that the discussion was not relevant to them,
even though the majority of them had an opinion about life-sustaining treatment
when asked, and a large number (46%) indicated dissatisfaction with their lack
of knowledge of comfort measures treatments that do not cure but keep patients
comfortable at the end of life.
A
March 2012 Ipsos-Reid
national poll found that 86% of Canadians have not heard of advance care
planning, and than less than half have had a discussion with a family member or
friend about healthcare treatments if they were ill and unable to communicate.
Only
9% had ever spoken to a healthcare provider about their wishes for care.
Another study is currently underway across Canada to examine advance care
planning from the perspective of health care providers.
The
Speak Up: start the conversation about end of life awareness campaign has
several valuable resources to help Canadians communicate their wishes,
including a website (www.advancecareplanning.ca ) with workbooks, wallet cards
and links to provincial / territorial legislation and planning information.
There are also tips and videos to help people begin these often difficult
conversations.
As
health care technologies and life saving interventions continue to improve and
people live longer many with complex medical conditions advance care planning
becomes increasingly important, says Dr. Heyland. We need to communicate our
values and wishes around the use of certain procedures at the end of life, and
what we believe gives our life meaning.
Here
are some resources to help
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