Advance Care Planning provides you with a voice in your health care
By Hilary Thome
Winnipeg Regional Health Authority
Published Friday, March 6, 2020
The ability to communicate with others is essential to the expression of who we are, what we believe and what we need. What happens then, when that ability is taken from us at a time of health crisis – when we do not have the capacity to share our wishes and our needs with our loved ones? How do we speak for ourselves when we have lost our voice?
The answer, is advance care planning.
Advance care planning is a process that helps you think about, talk about and share your thoughts and wishes about your future health care. It gives you a say in decision making, and helps you determine who would speak for you in the event that you were unable to communicate for yourself.
Working in home care has given me a greater appreciation for the importance of advance care planning. All too often, I’ve seen families suddenly thrust into situations where they are left to struggle with difficult health care decisions because their loved one hasn’t clearly shared their wishes and expectations for care. This lack of direction and clarity can – and often does – result in added stress and the potential for heated debate during an already difficult time.
No one wants that.
By taking the time to make your wishes known, your caregivers won’t be left wondering what you might, or might not, have wanted. Decisions made on your behalf will accurately reflect your wishes, based on your values and beliefs.
One of the ways advance care planning can ensure this happens is through the creation of a health care directive.
As a citizen of Manitoba, you have the right to accept or refuse medical treatment at any time. The Health Care Directives Act allows you to express your wishes about the amount and type of health care and treatment you want to receive in a written document should you become unable to communicate this information for yourself.
Sometimes called a living will, a health care directive also allows you to assign a proxy – that is, to give another person or persons the power to make medical decisions on your behalf should you ever be unable to make them for yourself. It also makes your wishes on topics such as organ and tissue donation crystal clear, something your family and friends may find comforting in a time of crisis.
Unlike a will, a health care directive can be prepared for free, without the need to hire a lawyer. The wishes you express in your directive are binding to your friends, relatives and health care professionals (unless they are not consistent with accepted health care practices) and will be honoured by the courts.
Another tool, often used in hospitals and personal care homes, is called a Goals of Care form. As its name implies, it’s used to help you to articulate the goals you have for your care. If, for instance, you had a terminal illness, what would your goals be? Would you want care aimed only at keeping you comfortable? Would you want to be put on a ventilator to help you breathe? Would you want to be fed through a tube, if necessary? Would you want someone to perform cardiopulmonary resuscitation (CPR) if your heart stopped? Those are some of the considerations that go into a Goals of Care discussion.
None of us can predict what tomorrow may bring, but we can plan ahead and make our wishes known. And the best time to engage in advance care planning is now, before a crisis occurs.
Knowing that this type of planning, and the conversations that go with it, can be difficult, the Winnipeg Regional Health Authority has developed a workbook to help guide you through the process. The workbook’s cover says it all: “Think about it. Talk about it. Share it.”
Whether you use this guide or have your own ideas in mind, the directions remain the same: think about your beliefs and values as they relate to your health care. Talk to your family and trusted friends to let them know what kind of care you would be willing to receive in a crisis, and what kind of care you would refuse. Share your plan in writing and make it readily available to family and friends in a time of crisis.
I believe – and I’ll bet you do, too – that everyone should have a say in their health care. The best way to ensure you have that say tomorrow is to plan for your future today.
Resources at your fingertips
For more information about advance care planning, visit wrha.mb.ca/advance-care-planning
For more information and a form for health care directives, visit gov.mb.ca/health/livingwill.html.
Hilary Thome is a Case Management Specialist with the WRHA’s Home Care program. This column was published in the Winnipeg Free Press on Friday, March 6, 2020.
