Many people think of advance care planning as being the same as filling out a living will or having a Do Not Resuscitate order in your medical file. But advance care planning is really more about the conversations that we have over time – with our family, our friends and our health team. A new project at the Vancouver Costal Health Authority is helping British Columbians better understand this process through workshops held by volunteers who introduce the concept of advance care planning as a gift to your family.
Margreth Tolson, staff with Community Engagement for the Health Authority, says that one of the larger challenges is helping workshop participants get past a focus on the documentation around planning. Our death denying culture has made it very difficult for people to think about and address the topics of death and dying, she says. We find that our facilitators really need to focus on the conversations aspect of the process rather than just quickly filling out a workbook and forgetting about it.
The workshops are led by community volunteers who receive training and resources to facilitate discussions, a public to public model that often helps to make the topic more approachable. The team works with participants to help them identify a Substitute Decision Maker and to think about the conversations they may want to have with that person, as well as other family members, friends or health professionals.
These conversations arent just about turning off respirators and removing feeding tubes they are about values, about what would be meaningful to you at the end of life. Your discussions may include your feelings about spiritual rituals, having family nearby, having music playing or whether youd prefer to be at home or in hospital.
And because no one is able to predict their own death, these conversations should continue as we age, or as circumstances change. For example, a divorce or death may mean a change in your Substitute Decision Maker.
Its important to remember that these conversations are not just for you research has shown that advance care planning significantly reduces stress, depression and anxiety in family members and caregivers who know your wishes and can act with confidence on your behalf. It truly is a gift to your family.
The end of life is just that life. Make sure you dont cheat yourself at the end speak up, and have the conversations that will give you and your family a meaningful end of life experience.
Louise Hanvey is a practicing Registered Nurse and the Project Manager for Advance Care Planning in Canada.