As our parents grow older, it's understandable that we have concerns for their future and well-being.
While most of our parents have made a Will with instructions on how their money and property will be distributed after they die, far fewer have started advance care planning (ACP), which provides a valuable roadmap to guide future medical decisions, should they reach a stage where they can no longer communicate.
New research shows that only 14% of Australians aged 65 and over are taking active steps to control their end-of-life care, with men less likely to plan than women. Given that around a third of people will be unable to make their own end-of-life decisions, this is a cause for concern.
Death and dying puts families under immense stress
Complex family relationships only make matters more difficult. ACP can help avoid family conflict and ensure the voice of the parent is heard above competing voices and family dynamics. ACP offers people the opportunity to clarify their medical treatment preferences in advance, preparing themselves and loved ones for a time when they can no longer communicate.
ACP can be as simple as a conversation about preferences for care or can be formalised with a legally-binding advance care directive (ACD) and the appointment of a substitute decision-maker (SDM) – the person empowered to make decisions on another's behalf.
We've compiled the following tips to help support your ageing parents with ACP.
1. Start talking
All too frequently, people have expectations that loved family can make decisions on their behalf without discussion. If your parents has appointed you as a SDM without the benefit of clarifying their preferences, be sure to raise it with them.
To kick off the conversation you might ask... “I’m worried that if something happened to you I wouldn’t know what you would want. Would you accept treatment if it meant you were unable to talk or recognise people?
2. Make sure the right person is appointed as SDM
The best person to appoint as SDM is someone who can remain calm under pressure and is located close by and is available. They should also fully understand the person’s values and preferences and be prepared to make decisions accordingly.
If your parents want to appoint you in the role of SDM, ask yourself if you're the right person for the role. If you're not great at making decisions under pressure or feel uneasy about discussing death or dying, be sure to let your parents know so that they can choose someone else.
3. Get it in writing
Just like making a Will, an advance care directive can help create certainty and clarity around a person’s wishes and reduce confusion and family conflict.
Encourage your parents to write an advance care directive while they are fit and healthy. Be aware that advance care directives can only be completed by people with decision-making capacity, so if dementia is a factor, early planning is critical.
4. Learn your CPRs and DNRs
While most of us have watched TV medical dramas and know the terminology, few of us have a solid grasp on how these play out in real life.
From cardiopulmonary resuscitation (CPR) and dialysis to tube feeding and artificial breathing, these life-prolonging interventions come with significant burdens that are not always compatible with how mum and dad want to live.
6. Access is everything
Too often, ACDs cannot be found quickly in an emergency situation. Encourage your parents to upload their ACD to My Health Record or ask their health professional to do so.
This will ensure the document can be accessed when needed most. Alternatively ask your parent for a copy so you can keep it safe and accessible.
7. Ask for help
Advance care planning is easier than most people think and does not require a solicitor. However, it is natural to have questions about what's right for your mum or dad.
We offer a free national helpline for both the public and health professionals. Call 1300 208 582, Mon-Fri, 9am-5pm AEST.