‘End-of-life’ care – the conversation experts say you need to have

Watch the video above: health professionals advocate palliative care planning

SASKATOON – Would your family know what to do you if you couldn’t communicate your end-of-life wishes? It’s a difficult conversation to have and one poll shows not enough people are having it.

“Would you want aggressive treatment at the end-of-life or would you like a treatment to be very attuned, individual to making you as very comfortable as possible so you can enjoy the time that you have left,” asked Anna-Marie Buhr, a senior social worker at the palliative care unit at St. Paul’s Hospital.

Questions not enough Canadians are asking each other. According to a new Harris-Decima poll, six out of ten Canadians believe it’s extremely important to talk to someone about their end-of-life care preferences and yet only 45 per cent have done so.

“First of all, do you have someone who will speak for you that knows they will speak for you if you can’t speak for yourself and secondly do you have wishes or desires or things that you want to see happen to you,” said Dr. Vivian Walker, co-medical director of the palliative care unit with the Saskatoon Health Region.

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According to the poll, earlier research indicates that patients who have these conversations are more likely to be satisfied with their care, require fewer aggressive interventions and place less strain on caregivers.

“I sometimes, and people in the general public as well, feel a little disempowered, like will the doctors know what’s best, but there is sort’ve obligation on the part of the physician and nursing team to do x, x, x unless families tell us otherwise,” said Walker.

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According to the poll, 39 per cent of people are “creeped out” by the conversation and one of the biggest reasons people are not having the discussion is because they’re afraid of death.

“Having conversations about what it is that bothers us or concerns or what our fears are with a professional who can answers those questions, I think that can give people a sense of peace,” said Buhr.

Experts recommend having the conversation on a yearly basis. Changes to your advance health care directive can be done as your health changes.

“I’ve just gone through two deaths in my family in the last while and the advanced care planning was absolutely instrumental in dealing with the decisions,”said Katherine Ash, associate professor at the University of Saskatchewan college of nursing.

Even though it was imperative in both cases, Ash says she still had a hard time starting the conversation.

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“I really struggled, I’m a nurse and I’ve seen many miracles happen, people that we thought were going to die that didn’t and that made me very leery about my own advance directive,” said Ash.

Ash would later have a change of heart and is now very much at peace with the advance directives she’s decided upon and didn’t want to run the risk of her family being divided.

“I myself didn’t just because the decisions are so complex.  It felt like, but as I said, my lawyer and watching my family member die brought it home to me that they need to be made and they’re not that difficult,” said Ash.

While it’s hard to pin-point an age to should start considering this, legally you can make a directive if you are 16 or older.

As the chair for Prairie Hospice Society Inc. and a lawyer, Kathryn Ford knows all too well the challenges of not having an advance health care directive.

“Healthcare providers can get caught in a bind of sorts, I mean I think we unfortunately live in a world where people are nervous about getting sued for making the wrong decisions and the legislation that covers advance care directives, if they’re done properly, they’re signed by the person themselves and witnessed appropriately it really does give protection that rely on that directive,” said Ford.

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According to the poll, those Canadians who do have an advance care plan are more engaged in the health care system,  90 per cent of them have a family physician or regular place of care.

“Some of the strides that have been made in medicines and so on, we’re living to incredibly old ages now and for some that’s great, for others that’s not so great and I think people need to set their minds to how the end of their lives will be and its important for doctors and lawyers to be helping them with that,” said Ford.

READ MORE: My loved one has passed away. What in the world should I do now?

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