When someone suggests that you should have an Advanced Care Directives, a very common response is to avoid that conversation because it can challenge you to think about life – and the end of it.
So let’s see how the Advance Care Directives (“ACD”) works and why it is good for you and your loved ones.
First of all – everyone with no formal ACD, people (for example, doctors and other medical providers) talk to (and may be) the most accessible person who is authorized by law to make that decision.
Governmental laws in medical conditions determine who can provide relevant consent and direction. This law sets the descending order of priority:
- At the top are a person (or persons) appointed under a formal ACD;
- At the lower end is a director of nursing in an aged care facility; and
- In between you have different family members of different levels of ‘kinship’, but who do not have any formal / legal documents to be able to decide on your behalf.
What if I do not have Advanced Care Directives?
Do you want everyone on the list to know what you want? And will they express your wishes in the same way or the way you want?
In other situations (non-medical), such as where you should live, there is no law authorizing anyone to make such a decision. Finally, the South Australian Civil and Administrative Tribunal (formerly the Board of Guardianship) will be contacted to appoint a suitable person or persons (who may also be public advocates) to make those decisions.
Of course, you may have the same, or similar, discussion about your wishes with all family members, but over time people can discuss with you in different ways and tensions can arise between those who desires know who knows best.
The second factor of course is the extent to which you may have provided guidance on many issues. For example, ‘Don’t revive me’ or ‘Pull the plug’ are obvious, but where you can live and what your priorities are for living (as opposed to dying) if your life is affected by dementia for an extended period of time Is period?
What Will Advanced Care Directives Do For Me?
A formal written Advanced Care Directives ensures that everyone has the same guidance and the ACD can specifically appoint a person (or individuals) who are authorized by you (not by government law) who want to know your wishes.
Furthermore, family members are known to come to the same issue with good intentions, but with different perspectives. These are often discovered in the most difficult times.
Consider this example:
If you lose mental capacity, but maintain good physical health, attention needs to be paid to matters such as what you want to do and / or experience and, often most importantly, where you can live and who can take care of you on a day- by day basis.
If your needs were such that nursing care was necessary, then how and where that care is delivered will become important. If, in the Advanced Care Directives, you expressed your desire to enter a nursing home, the family’s thinking that they were out, out of necessity, would ‘evaporate’ into the nursing home. Your statement in ACD will be in essence, a gift to those who make hard choices for your own good and will probably stop the argument on ‘what mum / dad would like or tolerate’.
In short, it will be a comfort for decision-makers to do exactly what you wish, seeing them in writing and knowing that they are the person (or persons) you have specifically appointed. The more thought and written guidance you give in your Advanced Care Directives, the more comfort and confidence you provide; A thoughtful gift for those who can be called upon to make difficult decisions
So, In Summaries
A written formal Advanced Care Directives will give certainty to everyone (that is, it will ensure that everyone you know knows what you want ‘) and you will give specific rights and comfort to those who are appointed as specific decision makers.