I LOVE being in control of the minutiae of my life and fear ending up in a rest home where the tea is not hot enough, the food not to my liking and people interrupt while I watch Coronation Street.
Some of my friends have impairments that preclude them from this form of control, so I know the power I wield is a rare and wonderful thing. I also know that my mental capacity to exert this power is unlikely to last till I take my last breath.
This is why I welcome the Advanced Care Planning system, being promoted by our district health board. When I can no longer make decisions, or communicate them, this process will enable the people who make decisions for me to know exactly what I would like. I just have to trust them to take notice of my wishes.
Our voice: to tatou reo (and yes, they forgo those pesky capitals) is the name of the DHB programme to support us all to prepare for the end of our lives.
If you are among the many who believe in your immortality then such planning might seem futile. But you may know that immortality is not likely for your friends and family, so you could at least support them to make future plans.
A couple of decades ago, when working as an advocate, I met the whanau of a woman who was dying in a rest home. The rest home was about to give her a dose of antibiotics that the doctor said might prolong her life by another three weeks.
The family felt her quality of life was very poor and did not want the antibiotics administered. In the absence of an advanced care plan that expressed their mother’s wishes, the rest home felt obliged to give her antibiotics.
Even though I welcome this opportunity, I admit that I prevaricated, finding ways to avoid planning for my death.
And a Maori friend said that talking about death can be seen to invite it. That seems a bit unnerving. But eventually, while on holiday, I asked some of my close friends to join me in considering questions such as:
Who do you like to spend time with? What would you miss most if you couldn’t live as you are used to? If you couldn’t think, walk or talk normally? What would an ideal death look like for you? When you think about dying what situations worry you? What kind of spiritual care do you want? Do you want to be buried or cremated?
While cooking dinner and sipping gin we made our plans. Most serious discussions are lightened by levity, and plenty of wild jokes permeated our conversation.
Later we reflected that our group and holiday setting, and maybe the gin, had made the process easier.
We were relaxed, not sitting around a table feeling morbid. We bounced ideas off each other and wondered if, contemplating our end of life on our own, we might have had a narrower focus.
The DHB brochure suggests involving close family can be helpful. However, where there are strong differences of opinion among those emotionally involved in our lives, it could also be fraught. The process is intended to ensure our wishes are foremost even where they don’t accord with other family members.
The Bill of Rights Act gives us the right to refuse treatment, and the Code of Consumer Rights underpins our right to make an advanced care plan (or advance directive). However, to be binding, your plan must meet certain criteria:
You must be competent at the time you make the directive; any decision to refuse treatment must be done freely without pressure from anyone else; and you must have intended it to apply in the current situation. If that is in doubt, the medical team will make a decision that is in your best interests.
Given those legal issues, having drafted my advance directive I will now discuss it with my general practitioner.
With a bit of luck she will testify to my sound mind, and ensure my decisions are based on full information.
My GP needs to have a copy, and one can be kept by Health Records, Whakatane.
I suspect immortality is unlikely for me. All good things come to an end and that will be true of my life. But at least I can try and ensure that, when it comes, my death is a good one.
Which reminds me, I still have to work on my playlist of songs and poems to keep me calm and focused as I move towards the end of my journey on this planet.
If this column has inspired you to plan, or if you want to know more, then I encourage you to come to our next public meeting. Lee Walters of the DHB will enlighten us on all aspects of Advanced Care Planning. Knox Presbyterian Church, Tuesday, March 10 March 10-12 noon.
By Ruth Gerzon