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Advance Care Directives / Medical Power of Attorney – Dad’s Journey
Expressing your wishes #1
Yes we are going legal with this blog today. And with such complex and divisive documents such as these, please read these thoughts as general in nature. Unless you are feeling absolutely confident with these matters, please use the expertise of a lawyer you are comfortable with. Make the choices, have the discussions while you still can. The last thing anyone would want to do is to make the interpretation of these wishes uncertain. Today we are going to look at Advance Care Directives / Medical Power of Attorney.
On saying this, there is nothing like practical examples of when these documents are used, to make a little more sense, and this was when my own Dad died in 2013. As a family we were able to discuss Dad’s wishes, so when the time came, matters were relatively straight forward. Mum died of a sudden brain tumor in 2002, and I suppose conversation was able to ‘spring’ from this. This is the first take away. Putting all of the documents aside for a minute, talk about this stuff. So when the time comes it is easier for all concerned. This includes all of the special possessions and memories. Talk, talk, talk, and then talk some more. What about computer passwords, as an example?
Dad experienced kidney failure at around the age of 70, and for this reason the last few years, dialysis was a part of his weekly journey. This started off in the home, but when this got too much, he went to a clinic three times a week. Things were starting to take their toll, and eventually his heart was compromised. There was surgery, which actually fixed the heart; it was unfortunate that the rest of the body could not keep up, including his leg where they took a vein becoming quite an ugly wound. They would give medication for the heart, which would ‘muck up’ the leg, and so they would give medication for the leg that would ‘muck up’ the heart.
Dad was in intensive care during this time, and was only a matter of time, if you include dialysis, for things to come to a head. There had been daily visits for around six months, and then the call came from the hospital. Dad had a seizure and was unconscious. Life had already changed, as Dad would be unable to go back to his unit, care was now needing to step up to alternate living arrangements.
I can still remember the scene. My sister and I looked at each other, and before the doctor came, we knew the time had come. Dialysis was due that evening, and we came to the decision that dialysis had now gone from been a life sustainer to a life support. After speaking with the medical staff about their thoughts, we decided that dialysis would not happen that evening. Ten hours later, with last visits, and surrounded by family, dad died.
Dad had insisted on putting Medical Powers of Attorney in place. To this day we are not sure whether this document was referred to, but for my sister and I, knowing this was in place, knew, in our heart of hearts, we could make this decision. Dad trusted us to make this decision on his behalf. In South Australia, the document is now called an Advance Care Directive (ACD) ; a form which prescribes and gives the power over your life and care to one or two ‘Substitute Decision Makers’ which is what my sister and I had become. We could not ask Dad about future dialysis; we had decide on his behalf.
Just some notes on ACDs in South Australia. Firstly, they must be on the Government prescribed form, not a typed up document. Secondly, they are only to deal with your physical care; legal and finances are covered by a Power of Attorney. Thirdly, you must know what you are doing, and a good witness will send family members out of the room to ensure this. And while we are on witnesses, I would encourage you to seek out a Justice of the Peace as the witness, because they usually are trained in what can be a complex document to witness. It is good to know a JP as you do need one from time to time.
Another saving grace with Dad was Health Insurance. I know it is expensive and we constantly question it. But we did get a statement from our health insurer after his death, and we were very happy to see that the $120,000 that went towards Dad’s hospital care was completely covered. How amazing was that! I am still thankful, to this day, the care Dad received in hospital. I am sure his case was frustrating to them, and medically there was a lot going on. We were always made to feel welcome and those final moments were peaceful.
Dad’s journey and how his wishes were carried out through his verbal and legal arrangements will continue in the next few blogs. I thought I would be able to do it on one, but I am going to need more, so they are not too long for you, the reader. I trust if you have not had these discussions with loved ones, that this blog may be the prompt you need.
The commentary in this blog is intended to be general in nature. It is just some observations from one fellow traveller in life to another. If anything in this blog raises issues for you, please call Lifeline on 13 11 14 or consult with a trusted medical professional. There is definitely some family discussion required here, together with legal advice.
Photo courtesy of https://advancecaredirectives.sa.gov.au