No body wants to think about dying. No body wants to think about the possibility they will lose functions and lose control of their bodies and, for a growing number of us, our ability to think clearly and make sound decisions. Yet we live in a time when, although we will have more people over 100 years old than any time in history in the next 10 years, we will also have more people with dementia than has ever been anticipated and planned for. Add
to this advances in medical science that contribute to the extension on the length of life.
Extended length of life means a lot of things. It can often mean a compromised level of functioning as a result of time and other impacts on health from the treatments used to extend that time.
Many people will live the last period of their later years in a state of frailty. They are likely to have periods of time where they have acute episodes of illness, weakness and long recovery times. All of these can be treated. Sometimes it can be treated with quite dramatic interventions, such as cardiopulmonary resuscitation (CPR) or kidney dialysis. It is uncommon for people to simply fall asleep in their homes and not wake up in Western society. We are more likely to die in hospital.
I'm not trying to stop people from having interventions, from seeking assistance in their later years. I am trying to encourage people to think about the possibilities. If people think about what they value about life, think about how they experience enjoyment and connectedness, it is a first step to being able to talk about Advance Care Planning. This is about telling your loved ones, or a specific substitute decision maker, what your wishes are in regard to health care if you were unable to express that decision yourself.
The key is to start thinking about it, then start talking about it. If you want, you even have the provision of writing it down as either a formal or informal document. Think about organ donorship, CPR, dialysis, unconsciousness, head injury, a persistent vegetative state, nutrition and hydration at end of life. Hard topics, but harder if you are asked the question for your loved one and don't have the answers.