At Kearney’s, we are great proponents of planning ahead for what you would want to happen when you die – that way you will have a say in whether you are buried or cremated and in what kind of service your loved ones will have for you.
We believe it is equally important for you to plan for the kind of health care you would want to receive if the time ever comes that you couldn’t speak for yourself.
The complexity of end-of-life care can be overwhelming for those who may need to make decisions on behalf of a loved one who is no longer capable to make them for him or herself. You can help them by indicating clearly, while you are able to do so, how you want your care and treatment carried out.
You can do this by communicating your wishes in writing or verbally to those who will make these decisions for you – family, friends and health care providers. It is important to remember that you will always be asked first as long as you are able to make your own decisions – as long as you can understand and communicate with your care providers. But there may come a time, due to illness or injury, that you will be incapable of expressing your wishes.
To try to detail what you would want in specific medical situations could result in the creation of complicated or even confusing instructions. For this reason, it is a good idea for you to chose a trusted individual who will make decisions for you that are in your best interests and in keeping with your beliefs and values about care at the end of life.
If you don’t designate a specific individual to speak for you by way of a Representation Agreement, there is a legal order in British Columbia legislation in which individuals will be approached to make health care decisions for you, starting with your spouse, your children, your parent, your sibling and the list goes on. The first step will be deciding who your advocate will be.
The next step is that all-important communication with your advocate. You can do this in writing or verbally. Having these kinds of conversations can be very difficult, but it is essential that you express your wishes while you are able to do so. This will make it much easier for your spokesperson to make your decisions with the confidence of knowing that it would be what you would decide if you could communicate.
You will probably not be able to cover every possibility of what could happen to you in future. For this reason, choosing a trusted advocate will ensure that he or she will make decisions based on your beliefs and values and with your best interests in mind.
You might want to think about whether you would want your care providers to attempt cardiopulmonary resuscitation if you were to experience a cardiac arrest. Depending on your specific circumstances, you may wish to forgo this procedure. We know that it doesn’t always work and can sometimes cause irreparable physical harm.
What about organ donation? If you wish to be considered as a donor, you must be registered with BC Transplant.
What would you want to happen if you were in a situation where your medical treatment was more of a burden to you than a benefit? Your treatment options can be made based on your subjective response to them. This might be in the case of chemo therapy for cancer or for kidney dialysis. It is perfectly acceptable for you to decide to forgo or discontinue these treatments. If you were unable to express your wishes about these and other things, your advocate can do so for you.
There are many other situations where decisions may be needed about your care, such as palliative care, dementia care, pastoral care and more.
We encourage you to do your planning in advance, whether or not you put your wishes in writing. Talk to your family, loved ones and physicians about the care and treatment you expect to receive when needed. The greater the number of people who are aware of what your choices are, the better the possibility that your wishes will be followed.
To help you plan, you may wish to go to www2.gov.bc.ca and download the Advance Care Planning Guide.
