Planning for the future

End-of-life planning can be hard to do. When you are healthy and well, it can seem like something that can wait. When you are ill, considering death can make it feel more immediate, and day-to-day life can take all of your energy and time.

But life can be unpredictable, and having a plan in place means your values, choices and preferences are documented. This alleviates some of the pressure on loved-ones who act as substitute decision makers if you are unable to communicate your wishes. It can also help the person making the plan clarify their feelings about what kind of medical care they want to receive, what kind of questions they want to ask their physicians and health care team, and how to discuss their wishes with family and loved ones.

There are several tools available to help you consider the issues and personal choices that surround the end of life. In BC, we have the My Voice workbook, which acts as both a tool for making decisions and a way of recording them. It is available in English, Punjabi and Simplified Chinese, and can be downloaded or a hard copy ordered through the link above.

Another tool for use in BC is Nidus Personal Planning Resource and Registry. This service offers both planning tools and online storage for your documents; if you select it as an option, the website allows your health authority and hospital access to your recorded wishes and plans. You can now also allow your GP, financial advisor or attorney access to your stored health directive documents. This helps to ensure that if you were not able to consent or refuse medical care, your beliefs and values would still be reflected in the care you received.

Finally, a third option, based in the U.S. but recommended by the palliative care physicians at the BC Cancer Agency, is PREPARE. Using a step-by-step approach and videos as well as checklists, it walks you through the process of considering who and how to designate a medical decision maker, how to communicate with your health care team, and decide what is important to you.

We all have our own vision of how the end of our lives will play out. Some of us want every possible treatment and intervention and some of us want avoid medical procedures at any cost. If your wishes and values are not recorded and you are not able to communicate, it will be up to your family or physicians to make those choices for you, and their choices may not be in line with what you actually wanted. Being proactive in addressing these issues with family and loved ones also gives you a chance to discuss questions or concerns they may have, and help them feel more confident they are making decisions you would have agreed with if the time comes for them to act as your substitute decision maker.