We will be holding at least one Advanced Health Care Planning workshop in November. If you are interested in attending, please call or email our office to be contacted when the date(s) and location are determined.
Could your documented and well-known end of life wishes have an impact on our emergency rooms? I think so!
I am not a health care worker and know very little about our health care system, other than from my personal observations. But hear me out. Keep reading.
Personal Care Homes
Our Personal Care Homes are full.
Many older seniors are waiting in our hospitals for a bed in a Personal Care Home (PCH). If our hospitals are holding patients for months waiting for a PCH bed, then other patients cannot be admitted to these regular hospital beds, either from emergency departments or for other elective procedures.
Those that have been admitted to the emergency beds are waiting for regular hospital beds so they can get procedures and recover. Those sitting in in the emergency rooms are waiting to get an initial assessment but need the beds in the emergency area to be opened up, so they can be seen for their emergency!
It is a bottleneck that could be partially improved if your stay in the Personal Care Home is shortened.
How do you ensure your stay in a PCH is not too long? Have an Advanced Health Care Plan documented and well known by your chosen medical decision maker.
Advanced Health Care Plans
There are many tools to help you with decisions about your end-of-life care.
Dying with Dignity Canada has free Advance Care Planning Kits and Health Care Directives to help you take the guesswork out of documenting your wishes.
If you do not have access to the internet to print off the documents, give us a call and we can have one printed for you ($20 to cover the printing costs).
Talk with your Family
In addition to documenting your wishes, it is so important that you talk with your family about your preferred end of life care. Your health care decision maker must know what you want or do not want.
These conversations may not be easy for most families. It may take you many attempts to easily talk about it with some family members. I hope at least some of your loved ones will be willing to hear about your requests.
You can even start the conversation by saying you read this article! Give them a copy!
How to get the Death you Want
As long as you are mentally able to make your own decisions and are physically able tocommunicate them, you have the right to:
- Accept, refuse, or stop any medical treatments, and to change your mind at any time
- Refuse nutrition (food) and hydration (water), either by mouth or artificial meanssuch as a tube
- Decline cardiopulmonary resuscitation (CPR), ensuring you obtain a do-not-resuscitate(DNR) order from your health care provider
But what happens when you are no longer mentally competent (dementia or coma or other serious illness or disease)? Who will make these decisions for you? And do they know your wishes?
I encourage you to take some time to discuss with your family members about what your thoughts are about life support if you should be hospitalized and need intensive care including the use of a ventilator or other life support measures.
If you have an older person in your family, would they want their dying extended? Or do they want to die natural? Ask them. Have the conversation. Can you respect their wishes and follow through with them when the time comes?
People of all ages should talk about this. I have seen serious injuries happen to young people and parents need to make tough decisions about medical procedures or long-term care for this loved one. If the discussion didn’t happen before the accident, then the parents and other family members are making unknown, heart-breaking decisions. It would have been much easier if they knew what the person would have wanted.
If you were in a serious accident and in a vegetative state with no chance of recovery, how long would you want to receive life support? Months? Years?
Think about it, talk about it.
Pull the Plug
Many of my clients agree that if it doesn’t look good (end of life), then “pull the plug”. But withdrawing life support is more than just pulling the plug. There may be no plug to pull.
Ending life support may require “no longer feed or provide hydration”. We need to discuss and understand it is not “starving to death”. Normally at the end of our life we no longer feel hunger. Dying naturally means our body slowly shuts down. Organs including our stomach and digestive system slowly stop working. It can be unnatural and possibly painful if we continue to feed and hydrate organs that have started shutting down.
These are not easy discussions, and it may take many attempts to get even a bit comfortable talking about it with your family.
I discuss estate planning and health care directives with many of my older clients. I am usually pretty blunt: if you are placed in a personal care home, how long do you want to be there?
Most people say they do not want to ever go to a personal care home. That may be your wish, but sometimes you can no longer stay in your own home. Unless your family can personally provide high level of care at home or be able to pay for 24 /7 care, you will likely end up in a Personal Care Home if you are at the end of your life.
Having a well thought out and documented Advance Care Plan, and someone who will follow through with your wishes, can ensure your stay at a personal care home is not any longer than it needs to be.
Strong Advocate
My father died naturally in a PCH without any artificial food or hydration. Gradually, he ate and drank less and less.And he was notforcibly givenany food or hydration unless he wanted it. No spoon feeding. He was 94, had lived a good long life, and did not want to be in the personal care home with dementia longer than needed; he did not consider that living with dignity. He was there only seven months. I was his strong advocate who needed to make sure his wishes were followed. They wanted to give him a meal replacement like “Boost” or “Ensure” because he wasn’t eating much. I said no, that would only extend his natural death; I said it is ok that he does not eat much: he is dying naturally.
What will your end of life look like? Imagine it, talk about it; and then get your Advanced Care Plan in place and talk to your family about it.
Call or email us to be added to our contact list for an upcoming workshop.
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 Co-op) or info@sataxes.ca