Have you ever thought about what kind of medical treatment you would want if you were to become seriously ill? Although it can be difficult to think about, taking the time to reflect on the wishes you have for future care will ensure that your medical treatment aligns with your goals, values and beliefs.
That’s what advance care planning (ACP) is all about. It’s the process of thinking about, communicating and writing down your wishes or instructions about future health care treatment. This ensures that the people closest to you know what kind of health and personal care you would or wouldn’t want if you were unable to make these decisions for yourself.
With National Advance Care Planning Day being observed on April 16th, the Marathon Family Health Team is encouraging you to take this great opportunity to start thinking about your goals of care, no matter your age or health status.
The importance of Advance Care Planning
If you became seriously ill or injured without warning (e.g. heart attack, severe pneumonia, motor vehicle accident) and couldn’t speak for yourself, would anyone know your wishes?
The future is uncertain. Life can take many twists and turns and things can happen suddenly. This is why it’s never too early to think about what matters to you and to prepare for the unexpected.
There’s a lot to think about when it comes to making an advance care plan. If you’re not sure where to start, consider following the steps below.
Step 1: Think about your current health condition
Do you have chronic health conditions such as diabetes, heart disease or history of stroke, high blood pressure, cancer, kidney problems or lung disease? If the answer is yes, consider talking to your healthcare provider to make sure you have accurate information about your health condition. This can help you make informed decisions based on your current health condition.
For example, if you have difficulties with daily life functioning (e.g. getting dressed, eating, walking), this may indicate that your body will not be able to cope as well with infection or illness. Understanding this could impact the decisions you make about your treatment if you were to suddenly become ill.
Step 2: Learn about what’s right for you based on your current health condition
Each of us needs to determine what medical treatments are right for us based on our own values and beliefs so that we can make sure we receive the medical care that we want in the future. For instance, some may value living longer regardless of the quality of their life, while others may choose not to prolong their life if they have no chance of recovery.
The following are questions you can consider asking yourself to help you determine what would be most important to you if you were to become seriously ill:
- Do I want chest compressions or defibrillation if my heart were to stop?
- If I need to be put on a ventilator to live, do I want that life support?
- Do I want medical or surgical therapies for my serious medical condition?
- Do I want to die naturally, or with the assistance of medical devices?
Step 3: Decide the right substitute decision-maker to speak on your behalf
Appoint the person you want to make decisions for you. This person will be considered your substitute decision-maker (SDM) and will be making decisions for you when you are incapable of doing so. For this reason, it’s important that you choose someone you trust. Having an SDM can reduce tough family conversations when you become too ill to communicate your wishes and goals of care.
When you find a SDM, you can choose to prepare a legal document called a Power of Attorney for Personal Care. A lawyer can help you prepare this document, or you can do it yourself by accessing the Ontario attorney general website: https://www.ontario.ca/page/office-public-guardian-and-trustee.
Step 4: Talk to your substitute decision-maker and health care provider about what’s important to you
Communicating your wishes with those closest to you is a key part of ACP. This can be the hardest part. Make sure to be clear about what’s important to you so that your SDM or loved ones understand how you would like to be cared for. No one will know what choices you would make unless you tell them.
Remember to also let your healthcare provider know about your ACP; they want to understand your wishes to ensure they are caring for you in a way that you would want. Your healthcare provider will provide treatments to keep you as comfortable as possible until your last day of life. But they will not take all necessary measures to prolong your life if that is not what you desire.
Step 5: Record your wishes, goals and who your substitute decision-maker is
Writing down your care plan helps ensure your wishes are clear to everyone. You may believe that the people closest to you know what you wish, but they may not.
Talking about death, ‘what ifs’ and future goals of care is not always easy. But having these conversations and making a plan are ways to give your loved ones the confidence to make decisions during a difficult time. You may never need your advance care plan – but if you do, you’ll be glad that you took important steps to make sure that your voice is heard when you cannot speak for yourself.
As you complete your Advance Care Plan, know that you can revise and modify it at any time.
For more information on advance care planning, visit the MFHT’s Advance Care Planning web page. While you’re there, consider completing and submitting your advance care plan online or downloading a copy to complete and bring to your doctor or nurse practitioner.