Salmon Arm’s Dr. Fiona McLellan, part of the Shuswap’s palliative care team, suggests people consider having a conversation with loved ones about advanced care planning, what would be important to them at end of life. (Martha Wickett - Salmon Arm Observer)

Shuswap doctor suggests ways to best talk about making end-of-life plans

Physician emphasizes it’s not about doom and gloom, but making use of time at home

What helps you get through difficult times? A friend? Your faith? Your cat?

What would be important to you if you were nearing the end of your life?

What are you most worried about? Being alone? Pain? Something else?

These kinds of questions are ones that can start conversations about Advanced Care Planning, the process of making sure that your wishes for the end of your life, whenever that may be, are known and respected.

Dr. Fiona McLellan is a member of the Shuswap’s palliative care team. Because National Advanced Care Planning Day is held in April, and because COVID-19 has prompted people to think about their mortality, McLellan wants to bring people’s attention to resources and supports that can help.

“The whole encouragement to have these conversations is actually to reduce suffering, so you can have your wishes known and have what you want, from the whole range of ‘I want you to do everything,’ to ‘I’d really rather just be comfortable,’” said McLellan.

“It’s not that there’s a right answer or proper way to respond, it’s so people know what you want in those circumstances rather than guessing, so we can offer what’s appropriate for your wishes and not what we think you want.”

Read more: Canadians rush to prepare their wills amid ongoing COVID-19 uncertainty

Read more: A personal look at assisted dying

McLellan said she’s seen the statistic that about 80 per cent of people have had some conversations with family members, or would like to have conversations about end-of-life care, but only about 10 per cent actually talk to their doctor about it.

“So there’s a lot of people who sometimes end up getting interventional care that they don’t want, just because they haven’t made their wishes known in advance.

“Another thing I have noticed over my many years in family practice is it’s really hard for families to be left at that moment to make decisions where they have to have those conversations. They’re very anxious about making the right decision or the responsibility of making that decision.”

McLellan said questions about values are easier to start a conversation than: would you ever want to go on a ventilator?

”Just opening up the conversation is the first goal, I would say. I think people are nervous and anxious about having those conversations; they worry about them and that’s why they don’t have them… Rather than getting into a nuts and bolts technical conversation about, would you want this to happen, would you want that to happen, it’s more about, what are your goals and wishes, what’s important to you?”

McLellan said some people are afraid that having these conversations will make others feel hopeless or feel worse. However, she said, studies show talking about end-of-life reduces anxiety and alleviates suffering.

Several resources are online which provide more information about an advanced care plan.

They include the Advanced care planning guide and www.advancedcareplanning.ca, the Conversation Project and the B.C Centre for Palliative Care website.

McLellan also said that although the doors of Shuswap Hospice Society are closed because of the coronavirus, “their phones and hearts are open,” ready to support people.

McLellan emphasizes that with so many people spending time at home together, this might be the perfect chance to strike up an uncomfortable conversation.

“There won’t be a better time. I think people think, well, I’ll do that later. The best times to have those conversations are when you’re well. Not when you’re sick or when you’re not able to speak for yourself. I think people find it easier to open up and talk when there’s not a crisis.”


marthawickett@saobserver.net
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