This is the second blogpost telling my story of making my end-of life arrangements. If you missed the first post catch up here!
In the first post I mentioned the reason why we should take a bit of time to think about and discuss the arrangements for end of life. The important things are end-of-life care, funeral arrangements and disposal of assets. You have to take into account that you may not be as competent in old age as you are now. The Irish Hospice Foundation has produced Think Ahead which deals with all these matters. But, for now I want to deal with the much simpler Advance Healthcare Directive. I’ll describe what it is, how to fill it in, and who needs to know about it.
What is an advance healthcare directive?
Well, it’s a way of formally making known to others what your wishes are for end-of-life care. You can download a copy of an Advance Healthcare Directive elsewhere or use this one. It’s a seven-page document that you fill in to fit in with your beliefs and wishes.
Page 1: Is a cover page, nothing needs to be completed here. Please do read the text. Note that the document can be printed and completed with pen, or alternatively it can be completed on your computer (it is an editable PDF), but even if this document is completed on a device, it still needs to be printed and signed.
Page 2: This page is basic identification —name and address, date of birth, PPS number — and a space for the names and contact information of three people to whom you have given a copy of the directive. (I chose— with their agreement — my wife, my daughter and my GP.)
Page 3: The third page deals with two general situations. The first is illnesses which make you unable to communicate or make decisions, but which are not actually life-threatening (such as brain damage from trauma or stroke.) The second situation is life-threatening illnesses. In both cases the condition has to be confirmed by two doctors. There is one section for each of these situations.
I have decided that I don’t want to be kept alive if I am unable to communicate or if I am seriously intellectually impaired without a reasonable chance of recovery. The law enables individuals to refuse treatments and the Advanced Healthcare Directive sets out your preferences about this.
So, in both scenarios I selected the option, ‘I refuse treatment aimed at prolonging or sustaining my life.’ (Palliative care to relieve suffering is specifically kept as an option.)
Page 4: The fourth page enables you to choose or refuse specific treatments, such as resuscitation (CPR), artificial ventilation or feeding etc.
The process is simple: on both pages 3 and 4 you just initial the options you want. (There is also space to put down choices for treatment for any chronic conditions.)
Page 5: The fifth page names someone you choose to take part in discussions about medical care if you are unable to communicate. That person is described as a ‘health care proxy’ and must sign to show that s/he agrees. Your health care proxy should be someone who knows you well and knows your wishes. Your GP adds his/her details to this page.
Page 6: is very simple and gives options for organ donation. Again, you just initial the options you want. (It’s probably a good idea if this does not conflict with the option on your driving licence.)
Page 7 : Last page (!) is the important legal bit. Two adults must witness you sign the document, add their signatures, addresses and the date. (A couple of neighbours did mine for me during the first lockdown!)
In the next post, I‘ll look at who needs to know about the your AHD and who you need to discuss it with.