Why you should be thinking about your end of life

This week is Advance Care Planning Week. For many of us, advance care planning is not a concept we have ever heard of. Although expectant parents often go through an often exhaustive process of preparing for the birth of a child — going to classes, talking to family, making a birth plan — when it comes to death there is little planning and very little conversation.

Interestingly, 59 per cent of Australians have a will in place to determine how their property will be divided after they die, and 30 per cent have appointed a Power of Attorney to make financial decisions if they lose the capacity to do so. However, new research just published in the Internal Medicine Journal shows few Australians have drawn up plans for the treatment they want – or don’t want – at the end of life.

Advance Care Planning Week aims to change that. It is all about raising awareness of the fact that you can choose, right now, what you want in the future as you approach end of life, and capture those choices in an Advance Care Directive as a road map for your future treatment.

An Advance Care Directive is your opportunity to influence the future care you want, in terms of treatments and services. It allows you to elect a substitute decision maker to speak on your behalf when you are unable to make decisions yourself. Your Directive can be as specific or personalised as you like, and can include instructions about where and how you wish to die - at home or in a hospital – and if you would like to have your family, friend or pet with you.

Planning advance care can start with a simple conversation about your values and preferences for future health and personal care as you approach end of life with your family, friends, carers and doctors. Whatever our age, we all have values and preferences about how we like to live. It’s also important to spend time planning for how might wish to die, or be treated if we are seriously ill.

It’s not unusual for families and friends to avoid conversations about death and illness, and this leaves loved ones with no guidance for decision-making in circumstances which are already difficult and emotional. An Advance Care Directive relieves loved ones of the responsibility to make decisions on your behalf under stress, while providing a guarantee that you will still be in control of those decisions.

The benefits of advanced care planning are scientifically proven. Recent research published in the British Medical Journal (BMJ) measured the impact of an Australian advanced care planning program on end of life care in elderly patients. The randomised, controlled trial found Advanced Care Planning improved end of life care and patient and family satisfaction, and reduced stress, anxiety and depression in surviving relatives. Advance Care Plans don’t have to be in the form of a legal document, although experts recommend drafting wills and Advance Care Plans at the same time. Advance care planning can just as effectively be an informal process, where you write down your wishes on paper.

Most importantly, your plan needs to be shared with those who will care for you should the need arise. You can now save your directive online in My Health Record, the Australian Government’s secure online summary of your health information, to inform treating doctors and hospitals that you have specific wishes about future medical treatments and care. Making important decisions about future care sooner rather than later provides you and your family with time to discuss what is really important, and allows you to maintain control.

- Jason Malone, IRT Care CEO