Advance Care Planning and the Need for Frank Conversations
Benjamin Freeland , MA | Communications Advisor , Palliative Institute , Covenant Health
If you had to decide whether to undergo uncomfortable treatments in the hopes that they might prolong your life , how would you decide ? If you needed to make health-care decisions for someone near you , would you know what was important to them ? Advance care planning ( ACP ) lets you reflect on and discuss your wishes for health and personal care ahead of these decisions . A single conversation can make all the difference .
Vic Mitchell has always been comfortable talking about loss . Born in Northern Ireland , Vic lost his father in the infamous 1953 Princess Victoria ferry disaster . While he grew up in a happy home with his mother and stepfather , he was always struck by his mother ’ s silence around his birth father .
“ She never talked about him ,” he said . “ That ’ s just how people coped .”
Vic ’ s openness to discussing death has persisted to the present and helped him navigate the loss of his wife Lori from leukemia in 2014 . “ It was out of the blue ,” says Vic of her illness . “ After diagnosis she underwent a bone marrow transplant . Tragically , the transplant worked except for one cell . She then recognized that to continue living she would have to continue chemotherapy for the rest of her life .”
For Lori , there was no question of what to do . She decided to prioritize comfort and forego further treatment .
“ She decided to stop treatments on Saturday , and she died Wednesday night ,” says Vic . “ It was that fast .”
In the years since , Vic has immersed himself in his work as a patient advisor for Alberta Health Services . In this role , he helps people begin their cancer journey and encourages them to communicate their wishes and draft personal directives , wills , and other instructions . He is also proactive in his own planning .
“ I ’ ve seen it be an absolute gong-show , where nobody knows what ’ s going on ,” he explains . “ Hence I always keep my Green Sleeve with instructions on top of the fridge . I recently had a Zoom meeting with my children , where we went over my will page by page and discussed the details . It ’ s important to talk about these things when you ’ re healthy because things can go south in an instant .”
Vic ’ s wife was fortunate enough to be able to communicate her wishes herself . In the case of David Schneider , it was a chance conversation many years prior with his mother that made the difference .
Several years ago , David and his sister arrived at their mother ’ s home to find her collapsed and unconscious on the floor . A hospital exam revealed she had suffered a severe internal brain injury from which she would likely never recover . David ’ s sister asked him and his other siblings if they knew anything about their mother ’ s wishes regarding medical efforts to prolong her life .
“ I recalled one casual conversation that I had had with her many years previous , when she made it very clear that she didn ’ t want any extraordinary care in hospital ,” David explains .
“ I shared that with my sister , and the hospital transferred her to the palliative care unit , where she died peacefully one week later . Had we not had that conversation , she might still be on life support today .” For David , this experience was a wake-up call to the importance of palliative care and advance care planning .
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