Barb Phillips - Thanadoula
"What you leave behind is not what is engraved in stone monuments, but what is woven into the lives of others." ~ Pericles
There are many misconceptions about end of living planning. Which documents are legal, and how best to communicate your wishes. For example, an Advance Medical Directive, commonly called a Living Will, is not a legal document recognized by Ontario law. Only a witnessed power of attorney for medical care/substitute decision maker, is considered legally binding.
As a community death-care practitioner, my services are holistic and are on a continuum of helping individuals and families plan for the future. Providing end of living planning documents ie. (advance care plans, estate planning and home funeral criteria, advance medical directives), to working with the dying person and family; accompanying and educating them throughout the death experience, facilitating family-led after death home care, and attending to spiritual or ceremonial needs as requested. As a Life-Cycle Celebrant® I am honoured to work with families and/or friends to create a highly personalized ceremony (funeral, memorial, celebration of life, interment, inurnment), that is a true reflection of the life and soul of the departed.
It’s important, therefore, to know how to clearly communicate your wishes both legally and with your loved ones and family.
Let’s talk about your choices, your beliefs, and how to ensure that they are fulfilled.
Death is an inescapable, singular inevitability for all of us. Yet, according to a recent national poll by Ipsos-Reid, 80% of Canadians do not have a written plan about what life-prolonging treatments they would accept or reject at the end of living. Fewer than half have discussed the issue with their families and loved ones. Only 46% have designated a substitute decision maker, someone to speak on their behalf if they became incapacitated. Too frequently, advance directives don’t reach the people who ultimately will have to execute them. The recent poll also showed that only 9% had discussed their wishes with their doctor. By planning ahead you will provide peace of mind for you, and your loved ones, ensuring that your wishes are known in the event of a debilitating illness or death. I can assist with this process, by documenting clear and concise records of your wishes and pertinent personal information.
An Estate Plan is a confidential record of your personal information. It will be of value to you, your family, lawyer, executor and the person holding the Power of Attorney.
Immediately following a death, confusion often reigns. The number of decisions to be made, and the amount of information to be gathered at such an emotional time, can be overwhelming. An Estate Plan is designed to provide you with a simple, yet effective method of making vital information available to those who will need it in the event of your death or debilitating illness.
Many of the choices you will be required to make about the end of life, will involve medical treatments. Doctors and others on the health care team will focus on these decisions. But you may not consider these decisions to be the most important ones. By having a Health Care Plan, you can outline how you wish to live out the remainder of your life, and how the family will continue to live after your death. Your ideas and wishes about the end of your life, being with your family , who you want to see, what you wish to do now, what should happen nearer the time of death, and what should happen after your death, should be where your focus lies.
What Might You Plan?
An advance medical personal directive is a legal document, that sets out treatments and care decisions that the patient would or would not want, should he/she ever lose the capacity to speak for themselves.
Advance care planning is not just a document, but a process of reflection. It is a conversation that you have with close family and friends about your values, wishes and beliefs, as well as the medical procedures, that you want and don’t want at the end of life. It includes discussions with your health care providers, to ensure that you have accurate medical information on which to base your decisions. It is about starting the conversations.
Advance care planning gives you the opportunity to make choices about your future personal care. It can give you the peace of mind that someone you know and trust, understands your wishes and will act on your behalf, should they ever need to do so.
Talking now about the kind of care you do and do not want, will reduce any anxiety that your family and friends may feel. It will also give them confidence to make decisions for you, if that should become necessary. This module would include: information about making a plan, a values history questionnaire, an understanding of medical procedures, and a sample plan.
Tips for Caregiving & End-of-Life
Acceptable Conditions
If you are in an acceptable condition, you may still enjoy a good quality of life. Four levels of care are available - palliative, limited, surgical and intensive - for the treatment of any life-threatening illness. Consideration of CPR, and feeding alternatives, are important when considering acceptable, and unacceptable illnesses. Determining personal care issues such as shelter, nutrition, restraints, safety, clothing, and hygiene are also important considerations when completing one’s medical directive.
Irreversible and Unacceptable Conditions
When a condition is considered irreversible, and unacceptable, there is no possibility of a complete recovery. ‘Irreversible’ means that the person will not recover function. ‘Unacceptable’ means that the disability is so severe, that the person would not want attempts made to prolong life.
The term "life-threatening illness" can be confusing. Since each of us has a different perception of what is considered "life-threatening" and may be able to accept and live with different disabilities, it’s important to know in advance what you would consider acceptable.
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