End-of-life care choices

Only you can know your end-of-life care choices, so write them down

End-of-life care isn’t something we like to focus on, but if we truly want to live well right to the very end and die well, it’s something we need to consider at some point in time – the sooner the better. Are you aware of your end-of-life care options? Have you spoken to your doctor about what types of care are available to you where you live? Do you understand the implications of the choices you are making? If you answered no to any of these questions, read on.

Many people don’t realise that they can make their own end-of-life care choices, so they give over their power to others whom they deem are more qualified to make those choices for them. Now I’m not talking euthanasia – I’m talking about the choices we can make about the type of care we want for the end of our natural life that will suit our life values and spiritual philosophy.

One of the best reports on dying well is the 2014 Grattan Institute’s Dying Well report by Hal Swerissen and Stephen Ducket (there’s a .pdf version to download below). The data they gathered stated that ‘a good death’ meant the following:

  • knowing when death is coming, and to understand what can be expected
  • being able to retain control of what happens
  • being afforded dignity and privacy
  • having control over pain relief and other symptom control
  • having choice and control over where death occurs (at home or elsewhere)
  • having access to information and expertise of whatever kind is necessary
  • having access to any spiritual or emotional support required
  • having access to hospice care in any location including home, not only in hospital
  • having control over who is present and who shares the end
  • being able to issue advance directives that ensure wishes are respected
  • having time to say goodbye, and control over other aspects of timing, and
  • being able to leave when it is time to go, and not to have life prolonged pointlessly

Of course, the circumstances of our death is unique to each of us, and you may actually not be able to achieve all or even many of these goals. But if you aspire to experiencing any of these, you need to think carefully about your end-of-life care choices, because the team that you gather around you (click here for guidance on designing your support team) at that time will be the people who put these things in place and advocate for your choices when you can’t.

Most importantly, you need to be clear about your end-of-life care choices and have the conversation with your next of kin and those who will be caring for you so they are clear about them and can work towards facilitating them.

Do this quick quiz to assess where you are in the journey towards ensuring your end-of-life care choices are met.

If it was clear that I was nearing the end of my life, I would want to:

   die without medical intervention

   try any proven intervention possible

   try experimental interventions

If I had a choice, I would prefer to die

   at home

   in a hospital

   in a hospice

There is someone I can trust who would be able to express and advocate for my end-of-life care choices when I can’t.

  YES         NO

I have spoken to them about it and they have agreed to be appointed to represent me if I were to find myself in a position where I couldn’t speak for myself.

  YES         NO

I have completed an

   Advance Care Directive

   Enduring Power of Attorney Form

   Enduring Guardian Form

   Binding Death Benefit Nomination Form

and my family knows where those documents are kept.

How did you go? Do you have some work to do? There’s no better time than now.

Grattan Institute’s Dying Well Report 2014

NSW Health Department Statement of Values Form 2013

What Does Dying Well Mean to You? Dying Well workshop tool

Australian Super’s Binding Death Benefit Nomination Form