The Seniors Health Network each month poses a question to health-care professionals.
This month, the following hypothetical question was posed to Cari Hoffmann, Fraser Health’s co-ordinator of advance care planning:
My husband and I are both aging although we are still healthy and well. We should be making arrangements for the time when we are not well or when one of us is approaching death. But we don’t know quite where to start?
The process of reflection and communication – thinking about what you enjoy in life and what activities give your life meaning, and sharing these thoughts with those people you are close with – is the beginning of the process called ‘advance care planning.’
Many people think this kind of planning is solely about medical procedures – whether you would want to be resuscitated if your heart stopped, or ventilated if you were unable to breathe on your own, or fed by tube if you were unable to swallow. Yes, researching treatment options that you may face in the future because of particular illnesses you have could be part of the advance care planning process. But for most of us, deciding this ahead of time is difficult.
That is why I suggest you start the process of establishing your future care wishes by asking yourself these fundamental questions: What matters most to me? What does living well mean?
Identify your current values and beliefs, now, while you are healthy. If you focus on your values, questions like ‘Do I want to be hooked up to a machine, or be tube fed?’ become less relevant. The focus shifts to, ‘What gives my life meaning and how will an intervention support it?’
What if you needed a machine to help you live a meaningful life? What if a machine or a treatment in the short term would mean you could continue to participate in the activities that are meaningful to you such as travel or walking your dog or going to the movies? Would you still say no?
On the other hand, what if an intervention would prolong your life but not ensure you remained able to participate in life as you know it? Would you still say yes?
Thinking about this can be difficult. Having these conversations can be tough; adult children often shy away from considering their parents’ deaths, and other emotional issues between family members may surface. But why leave them to guess? It will give them peace of mind knowing the decisions they may be called upon to make will be the right ones, the ones you would make for yourself if you were able.
Follow up the conversations by documenting your values, beliefs and wishes (see resources below). Talk with your doctor about what interventions you may need to consider down the road. Think about whom you trust who would honour your wishes if you were unable to make your own health care decisions. Consider naming a substitute decision-maker through a representation agreement.
Planning ahead of time is a gift you give your family.
Resources to help you plan:
• For B.C. resources visit http://www.fraserhealth.ca/your-care/advance-care-planning/resources/
• For national information about advance care planning and a number of tools and resources to make a plan and start the conversation, visit www.advancecareplanning.ca
• Helpful videos: Advance Care Planning – Five Steps https://www.youtube.com/watch?v=Z8l8npWtnUI
Advance Care Planning – Don’t Take Chances https://www.youtube.com/watch?v=vxPF3XNZZWg
The South Surrey White Rock Seniors Health Network is a coalition of seniors’ service providers funded by the Peace Arch Hospital & Community Health Foundation, and working under the auspices of the Mayor of White Rock’s office. If you have a question for publication, please email seniorshealthnetworksswr@gmail.com
