It happens to us all. Death is the end we all share. It can come anticipated, even gently, as the natural end of a long life or it can come suddenly, unexpectedly, or after a long illness.
We die. It’s a really good idea to know what we want the aftermath to look like: do you want to be cremated or buried? Do you envision a traditional funeral or a celebration of life? Have you written your will and left your loved ones special remembrances? Have you said your goodbyes? Have you written down your wishes? This is the stuff of dying.
Advance care planning is not about dying. It’s about how you want to live until you die. Advance care planning is deciding what healthcare treatments you would agree to, or refuse, if you became incapable of speaking for yourself.
However the end comes, we of the dominant culture in North America tend to be unprepared. Most of us would rather not ‘see the doctor’, let alone imagine ourselves facing a critical injury or end of life scenario.
We do not know if or when we might be in a critical condition, leaving medical professionals and loved ones making healthcare decisions for us. We can’t predict or plan the time or the manner of our death, but should we end up in medical care due to accident or illness, most of the decisions about our care are ours to make in advance. And we need to write them down and share them with the people we love and with our doctors.
Doctors are there to save lives. Families often have a hard time saying no to life prolonging treatments. Do you know what you want? Some of the most difficult questions to face are the ‘what ifs’ around life prolonging medical interventions. Have you thought about the possibility of being kept alive artificially on life support? You may choose to be kept alive no matter the circumstances, or you may prefer to allow yourself a natural death while being provided with comfort and care.
These are difficult questions but imagine someone you love having to make these decisions for you when you are in a critical situation. We save our loved ones the anguish and guilt of making the wrong choice and we give doctors the information they need, when they need it.
Advance care planning is about making a plan for your future health care while you’re still able to make healthcare decisions for yourself. If you are well and healthy, now is the time. Don’t wait till you find yourself unable to speak your mind. Consider the possibility that you may be in a serious accident or you’ve received a diagnosis of a serious illness. So long as you can say yes or no to a course of treatment you will be asked directly, but if you are unable to speak or make decisions, your advance care plan will speak for you. You can review, change, or tear up an advance care plan anytime. It’s your choice.
The BC Ministry of Health provides the excellent guide and workbook called “My Voice: Expressing My Wishes for Future Health Care Treatment”. It is available online www.health.gov.bc.ca/library/publications/year/2013/MyVoice-AdvanceCarePlanningGuide.pdf and in hard copy from Crown Publications, Queen’s Printer for British Columbia www.crownpub.bc.ca/Product/Details/7610003494_S. The first part of the guide explains what advance care planning is and how to do it, and the second part is a workbook with tear-out pages to make a personalized advance care plan, including optional representation agreement and advance directive forms, which can be completed without having to visit a lawyer or notary public.
That’s the meat of the matter. The links will take you to the guide, and from there it is a matter of taking the time to give some serious thought to potentially life altering decisions. Talk with the people you love. Share your values and wishes for medical treatment as you consider the ‘what ifs’.
These written plans and directives are only in force when you cannot speak for yourself. If you are old enough to have a driver’s license, you are old enough to make an advance care plan. Get together with a family member or close friend and talk it through. Use the guide. It’s free online. Connect with us in Williams Lake at Cariboo Community Deathcaring Network where we celebrate life and talk about death.
Written by Nicola Finch, originally published by the Green Gazette. Nicola lives off-grid in a remote area west of Williams Lake. She and her husband are co-owners of Touch Wood Rings. They offer custom handcrafted wooden rings including wooden memorial rings inlaid with the ashes of a loved one. Nicola’s passion is holistic end-of-life care, from the work of death doulas to Green burials. She is a founding member of the Cariboo Community Deathcaring Network. Contact firstname.lastname@example.org
Cariboo Community Deathcaring Network will be offering a workshop on Advance Care planning in the next few months. Let us know if you are interested.
At our workshop we will also be discussing:
MOST stands for “Medical Orders for Scope of Treatment”. MOST is a doctor's order that has seven different levels of treatment that range from comfort care to intensive care. This form will be filled out with your physician, however, it is good to understand what it's all about and have your homework done.
No CPR Form Some people may want to record their wish not to have cardiopulmonary resuscitation (CPR) or other emergency medical procedures provided by first responders or other healthcare providers if their heart or lungs suddenly stop. h