We are in the final stages of completing our workshops on Personal Planning, including Advanced Directives, Representation Agreements, Advanced Care Planning, Power of Attorney and Wills. I have been taking the lead on the information on these topics and working with a very effective team that keeps me focused and on track. This is a big topic and one that is important for all of us.
As I have looked at all of the issues surrounding this topic, one fact jumps out at me over and over again. Communications with your loved one are the key to making your wishes known.
As you prepare the legal and informal documents, I think it is your responsibility to make sure that your loved ones understand what you want. Don’t just give them your representation agreement or your advance directive. Talk to them. Just because they have copies of your advance directives doesn’t mean they will understand what you want for every possible scenario.
No one knows what tomorrow will bring. My wife had a brain aneurysm three years ago and was given a 15% chance of survival. I had to make some very serious health care decisions for her, and I did. She fully recovered, not because of anything I did, but because of the excellent health care in Australia, specifically the Alfred Hospitals in Melbourne. So I know from personal experience that a serious accident or illness can result in you being incapable of making your own health care decisions at the time care is needed.
An advance care plan allows for such a possibility. It provides family or close friends and health care providers with a guide to your care and treatment, based on your wishes. An advance care plan can answer:
• Who do you want to make your health care decisions for you?
• What health care treatment(s) do you agree to or refuse if a health care provider recommends them?
• Would you accept or refuse life support and life-prolonging medical interventions for certain conditions?
• What are your preferences should you need residential care and not be able to be cared for at home?
• Do you want to be buried, cremated or use some method of body donation? Do you want to donate organs or tissues?
• Do you want to receive fluid intravenously (IV) or nutrition with a feeding tube if you can’t drink or eat on your own? If you will never again be able to drink or eat on your own, at what point do you want to stop intubation?
• How do you feel about the use of equipment if your kidneys or other organs shut down or you can’t breathe on your own and the condition could be long-term?
• If your breathing or heart stops, do you want paddles or CPR used to bring those functions back?
• What if you have a serious illness like Alzheimer’s, cancer, chronic obstructive pulmonary disease (COPD), congestive heart failure, kidney disease or Parkinson’s? Would you want palliative care to help relieve pain and keep you comfortable?
If you’re the agent named to make medical decisions for a senior loved one, it’s crucial for your loved one to communicate personal preferences with other family members.
Everyone in the immediate family orbit needs to know what your wishes are. Advance care planning is about having conversations with your close family, friends and health care provider(s) so that they know the health care treatment you wish to have or refuse if you become incapable of expressing your own decisions.
Writing down your beliefs, values and wishes for future health care is an advance care plan. Your advance care plan may also include additional legal documents.
In British Columbia, health care providers are expected to respect an adult’s wishes for health care that they expressed while capable. Whether you have expressed your wishes in an advance care plan or not, health care providers will make medically appropriate treatment recommendations for you.
Making an advance care plan lets others know the decisions you would make for yourself and will give your family and friends the knowledge and tools they need for the future. An advance care plan is a choice. It is a choice that will help alleviate some of the stress your family and friends could face if they are asked to make important health care decisions for you.
There is no way to know what someone might want in every possible situation, but a frank discussion now with your parent or senior loved one can reveal information that could help you with weighty health care decisions later.
Just like the three rules of real estate are location, location, location, the three keys to successfully advocating the health care wishes of your loved one are communication, communication, communication, starting on the day you are first appointed to carry out those future wishes, when not if you are in that situation.
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