This is my open letter to my family if I am placed in a Personal Care Home or a Nursing Home or a Long Term Care facility.

If I am able to speak for myself, I will tell the health care professionals that my wish is to be comfortable and pain free, but you can take me off all other medications that were intended to help me live longer. You can stop all meds for high blood pressure, blood thinners, cholesterol, or any medication for a heart condition or other ailment. These medications may extend my life, but that is not what I want once I am living in a nursing home.

So I tell my family (especially my health care proxy whom will speak for me if I cannot) to do the same if I am not able to speak for myself:

If I cannot tell the doctors and nurses myself, then you must tell them on my behalf: only meds that will keep me comfortable and pain free. All other meds are to be discontinued.

If I have dementia, and it is so severe that I cannot eat on my own, or go to the bathroom on my own, and I am unable to recognize family or friends for three months, you can discontinue my usual medications and only give me meds that keep me comfortable and as pain free as possible. And do not give me food or water unless I request it. Do not force me to eat or drink; at the end of life, when my body is shutting down, I do not consider it “starving to death”

These are the conversations we should have with our family now, regardless of our age or our state of health.

I am talking about allowing me to have a natural death. I am concerned about dignity and quality of life, not quantity of days in a personal care home.

And I am not referring to medical assistance in dying.

I encourage you to make this your immediate goal: to get an advanced health care directive completed and signed and discussed with your family. Then you can get on with life knowing that whenever you near your end of life, your family knows and will follow your wishes. Of course you should review the document regularly with your family (and doctor) every few years, and more frequently as we age.

There are many tools for you to use to get started. Here are a few websites to look at. has a great tool to ponder what you would want at the end of your life; I recommend just searching: dying with dignity advanced care directive, then scroll down to “Manitoba” to go the section that helps you complete the Advanced Care Directive that is applicable to Manitobans. is also a good one. Although based in the US, almost all of the info is applicable to Canada too. is also a good one; the simple two page contract available here is what I help my clients complete and for them to review with their family and doctor. The book that may help you understand the contract is called “A Better Way of Dying” and I have many copies at my office, please drop by to borrow one.

I also encourage you to search “In the Presence of a Spoon” and listen to the CBC audio of a woman in a nursing home.

If you are not comfortable accessing the internet for this type of information, or not able to print, please stop by our office so we can give you some of this information. We have copies of the Advance Care Planning Kit for Manitoba available for $15 to cover the printing costs.

I have also recently launched: Coffee with the Death & Tax Lady, every Saturday 10-11 am at my office. This is an open public discussion on anything related to taxes or end of life issues. It’s an open forum for anyone to attend and share their experience with others or ask questions. This is similar to the Death Cafés I have been hosting over the years, but no need to pre-register. Just come.

Anni Markmann is a Personal Income Tax Professional and Certified Financial Planner; living, working, and volunteering in our community. Contact Ste Anne Tax Service at 204.422.6631 or 36 Dawson Road in Ste Anne (near Clearview Co-op) or