We know that death is a certainty but how many of us are prepared for this eventuality? What would happen if you had an accident or you suddenly became ill? Would your family know what kind of treatment you would want or how you would like to be cared for?
Director Palliative Care Services Alison Parr at St John of God Murdoch Community Hospice says most of us don’t feel ready to broach the subject of end of-life care with loved ones but that it’s a conversation worth having at any time of life – young or old, well or ill.
“It’s not always easy to talk about, but sharing and recording your wishes will not only help to ensure you receive care in accordance with your wishes, but will also help alleviate stress for your family, who might otherwise be faced with making difficult decisions about your care without being confident of your wishes,” Dr Parr says.
“It’s also good to remember that it’s not a final plan – you can change your mind at any time, even if you aren’t able to make decisions for yourself.”
The reluctance in our society to talk about death means that our wishes are often not expressed or heard while we are still able to make them known. In fact, surveys consistently show that whilst between 60 and 70 per cent of Australians want to die at home, most of us die in hospitals. ³
“Around forty per cent of deaths are expected, so that’s a huge number of people in the community we could support
and help to die at home if that is what they wish.”
“By linking people with community palliative care services, we can help ensure their comfort and dignity, rather than subjecting them to an ambulance journey and a wait in the emergency department that isn’t actually going to improve outcomes.”
If you have firm thoughts about what you would and wouldn’t want in certain circumstances, it might be time for you to document and share them with the important people in your life.
It is now easy to record your wishes – visit advancecareplanning.org.au to download an Advanced Health Directive (a legal document) and an Advanced Care Plan (includes additional personal wishes not covered in other formal documents).
An Advanced Care Plan details how you wish to receive medical care in the event that you become too unwell to make decisions for yourself. If you are no longer able to make decisions or communicate with doctors, they will use your advanced care plan to ensure that your treatment proceeds according to your wishes.
“Advanced care planning is about openness and honesty,” Dr Parr says. “It’s also about making sure that people are aware of the limitations of medicine; that they are aware of their prognosis with and without certain interventions so
that they can make much more informed choices.”
“It also helps us ensure we’re using precious resources in the best way.” We also have to acknowledge that not everybody wants to plan and think ahead.
“Some people prefer to cope day-to-day but it’s still important for them to have opportunities to ask questions and for us to be prepared to have the conversation at the time that feels right for them.”
For more on broaching the subject of death with your loved ones, visit deathoverdinner.org.au
³. Foreman LM, Hunt RW, Luke CG, Roder DM. Factors predictive of preferred place of death in the general population of South Australia. Palliat Med 2006; 20: 447-453.