Kiwis encouraged to note death wishes in an Advanced Care Plan for family and medical staff

5 Apr 2018 | Advance Care Planning

This article was originally published on the NZ Herald online.

Today, Thursday 5 April 2018 is national Advance Care Planning Day. 

An advance care plan clearly documents your wishes for end-of-life care and gives everyone, including your family, a chance to think about what's important. This includes thinking about what health care you would, or would not, want.

Arthur Te Anini spoke to the NZ Herald about advance care planning and why it is important to him.

For a South Auckland man with chronic breathing issues it was a weight off his chest to be able to plan his final days.

When the time comes, Arthur Te Anini has chosen to have close whānau surrounding him.

"If I can hear them in the room just laughing, joking and talking I'd be very comfortable to just float away. That'd be wonderful."

Te Anini has chronic obstructive pulmonary disease, which is an umbrella term for emphysema, chronic bronchitis and chronic asthma which Te Anini knows will limit his life.

The 68-year-old Clendon man is one Kiwi who has made an advance care plan - a document that describes what is important to you as well as the healthcare and treatments you want.

He is encouraging other seniors to put their wishes into writing for Advance Care Planning Day this Thursday.

"This is a pretty good idea for me. I am chronically ill. This plan puts in place care and advised my family what to do. The thing I thought was brilliant is it is a guide for the medical team for my end-of-life care.

"Once you get your plan made you start living. You stop worrying what's going to happen to my cat and my car.

"My death will be quite easy, it's all in the plan!"

But it wasn't easy facing those sensitive questions. It took Te Anini five goes to complete the plan and now the Ngati Whanaunga man is passionate about sharing the idea. He promotes the idea at marae around the country.

He said Maori in particular did not like discussing death as it was seen as private and taboo. But he had experienced many deaths which put huge pressure on surviving family to sort out the person's wishes.

Te Anini's plan is detailed. He wanted to be remembered for his achievements, the people he had met and helped. He also wanted people to recall his "favourite party trick" where he recites a paragraph using words that start with each letter of the alphabet consecutively.

"I have instructions I want to be clean shaven, I want my fingernails clipped, I want the hair plucked out of my ears and nose, my face oiled and I want to be smelling of Old Spice. I want to be very presentable," he explained to the Herald.

"These are things that are important to me. They recognise I had a celebrated life and had important values.

A freely available template includes questions about happiness, routine and religious beliefs.

Then it delves deeper to document how much say you want in future decisions, whether you want to know how long you have left to live and how much information should be given out to loved ones about your health. It asks where you would like to die, where family can find your will, your wishes for organ donation and whether you want to be buried or cremated.

Advance care planning clinical lead Dr Barry Snow said research showed that when people understood their future they become less afraid, less depressed, less anxious and they live longer. They tend to spend less time in hospital and are more likely to do what they have always wanted to do and die in a way they have chosen.

"Most people when dying aren't able to communicate or are not in a position to think carefully," Snow explained.

"So a practicing doctor like myself in an emergency room with a semi-conscious patient will go to the relatives and ask 'what did he or she want?'. And they don't know ... We need people to talk about their preferences."

The advanced care plan concept has been around for 15 to 20 years but had really increased in the last seven years, Snow said.

If the End of Life Choice Bill, currently before Parliament, was passed into law an Advance Care Plan may also be a place people could specify their wishes. But Snow said doctors preferred to work with patients to problem solve the reasons they wanted to die, such as a pain management plan.

Snow admitted it was hard to raise the topic but it was important, particularly if someone has a chronic illness or is elderly.

"Nobody lives forever."

Advance care plans can be completed online here

Last updated 05/04/2018