End-Of-Life Planning

You may find it difficult to think about, but at some point, a time will come for you to make essential decisions to ensure your affairs are in order. Having a plan in place makes for a smoother process so your loved ones can make sure your last wishes are followed.

Let’s have a look at the following to help with your end of life plans.

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If you are in a position to determine life-sustaining treatment and you and your loved ones think it may not help your medical condition or just simply prolong your suffering, you have the right to refuse any medical treatments. You may refuse treatments based on your religion, or think they are too expensive or risky if they won’t restore your quality of life.  You may have other things you want to do with the time left or you feel the treatment is too dehumanizing for you. You have the right to start or stop treatment at any time. As long as you have been given the necessary information about the treatment options and the risks and benefits, including the risks and benefits of turning down treatment, your wishes do come first. Examples of treatments you can refuse include the following that you can include in your End-Of-Life Plans:

• Mechanical ventilation
• Dialysis machines
• Chemotherapy, radiation
• Medications to restart your heart
• Antibiotics
• Artificial nutrition and hydration (tube feedings)
• Blood transfusions
• CPR
• Antibiotics
• Spoon feeding

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If you are incapable of making decisions whether it is financial, medical or legal, it is important to identify a legal designate (power of attorney, proxy etc.) to make these decisions for you. Go over your end-of-life plans with the person you choose to ensure they understand and support your wishes. It doesn’t have to be a loved one but should be someone you trust (lawyer, financial advisor etc.), is good at handling money and would not cause them stress they cannot handle. If you do not have a legal designate in place, your loved ones will need to go to court to get the legal authority to handle your affairs which can be expensive and time consuming. There is also no guarantee the court will grant the legal powers to that person.

You can choose more than one and also a backup legal designate.  If things change, or your legal designate is incapable or traveling, a back-up or co-decision-maker is helpful. If you choose more than one legal designate, you need to establish if they can make decisions separately or together.

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You will want to consider the list below as to what you should include in your End-Of-Life Plan:

• A list of passwords for your phone, tablet, computer, email, social media accounts etc.
• Write down what you wish to happen with your social media accounts (memorial page or deleted for example).
• Document your bank account information, including safe-deposit box locations, paypal accounts, cryptocurrencies.
• Create a list of any life insurance policies and beneficiaries, as well as pre-paid burial plot or funeral insurance.
• Create a will if you haven’t already or if one exists, make sure it is up to date and includes digital assets.
• Make a list of bills with due dates and amounts and how the bills are received (email or postal delivery).
• Document any websites, blogs or other sites you maintain, e-commerce seller acounts (amazon, ebay etc.), subscriptions, loyalty/reward programs.

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Medical Assistance in Dying is legal in many places around the world. Check with your government agency to determine if you can receive this medical assistance. If it is legal in your locale, a doctor or nurse practitioner would administer or prescribe a substance at your request that hastens your death. You must meet certain legal criteria before the procedure can be administered.

Criteria may include:

• Has a serious and incurable illness, disease or disability.
• Meets the legal age requirement and are capable of making decisions related to this matter.
• Has made a request for assisted dying that was not made as a result of pressure from others.
• Has given informed consent to receive assisted dying after having been informed of all of options available to relieve suffering, including palliative care.
• Has requested assisted dying at the time you wish to receive it.
•  In an advanced state of irreversible decline in capability.
• The illness, disease or disability or state of decline causes enduring physical or psychological suffering that is intolerable and cannot be relieved under conditions that you consider acceptable.
• The natural death has become reasonably foreseeable, taking into account all of the medical circumstances, without a prognosis necessarily having been made as to the specific length of time you have remaining.

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Dying is very much a spiritual journey.  You will feel many emotions as you face the end of life and prepare for death. These are normal reactions and are part of your process. You should consider documenting your spiritual wishes for your End-Of-Life Plan.

The following are some thoughts and feelings you may experience and may wish to discuss with a spiritual advisor or counselor:

• Asking “Why Me?”
• Fear of being alone, of dying, of going to sleep
• Increased desire for physical affection or touch
• Increased desire to have loved ones close by followed by withdrawing from relationships
• Loss of interest in usual activities
• Feelings of embarrassment about being dependent on others and being a burden
• Feelings of denial, guilt, or anger about changes, relationships, or life
• Wanting to talk about the past
• Returning to religious practices or losing faith in religious beliefs
• Seeing or talking with dead loved ones
• Experiencing spiritual being or phenomenon such as angels, bright light, visions

Here are some items you may want to consider in your plan:

• Personal Care – Would you like massage or your favourite music played? Do you want people around, friends or loved ones?
• Obituary – Do you want to write your own obituary so you have some control over how you want to be remembered.
• Legacy – Do you need to prepare letters, notes, videos or special gifts to leave to loved ones? Do you want to have conversations with certain people?
• Post death arrangements – Do you want a green burial, a traditional religious ceremony, home funeral, cremation or body left for research? Perhaps an alternative ceremony or celebration with dancing, humour and favourite foods served.

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End-of-life planning is not easy but making these decisions ahead of time can offer you peace of mind and for those making arrangements.