How stating your wishes is a way of looking after everyone.
By talking to my parents about death and their future preferences, I discovered these conversations are a wonderful gift for all of us.
What is an Advance Care Directive?
I recently helped my parents to prepare their own Advance Care Directives (ACDs). It’s a legal document that states your wishes in the event that you’re not able to make a decision or communicate what you want. It can cover anything from healthcare options to end-of-life arrangements.
I’ve done all the necessary training, read the relevant documents and even familiarised myself with the latest legislation, the Medical Treatment Planning and Decisions Act 2016 (Victoria) which took effect on 12 March 2018. I’ve also got direct experience helping people with ACDs in aged care.
Asking interesting questions
My parents are both wonderfully well and, so far, haven’t had any serious illnesses. They are not dying any time soon. (And yes, I’m very happy about that!) I mean, how hard could it be to help my own parents with ACDs? As it turns out, quite hard.
Mum, Dad and I gathered around the lounge room coffee table to work it all out, my two young children sitting close by and eagerly soaking up the fascinating conversation about death.
Incidentally, as a result, my five-year-old son keeps asking questions like: “what happens to our eyeballs when we die?” And, “where does our heart go after we die?” In my mind, these are damn good questions. But let’s not get distracted with that now—it’s surely a matter for another day or another blog post.
Discovering each other’s limits
My mother, quite fairly, declared that she doesn’t want to end up immobilised, drooling, unable to recognise us or care for herself. At this point, my nine-year-old daughter (with nothing but kindness on her mind), suggested we’d happily provide her with bibs should drooling occur (of course, this was met with raucous laughter). Ah, children make such great guests at conversations about death.
Next, my dear father, a fit and lean man who, perplexingly, loves vegetables more than candy and cake (if only I had inherited such taste buds), opts for no cardiopulmonary resuscitation (CPR). None. Nothing. Not ever, under any circumstances.
The daughter in me wished to politely receive his request for no CPR, stamp it ‘DENIED’, return it and ask him to come back to me only when he’s had a bloody good think about it!
It’s about them, even when it affects me
The Doula in me knew better, (oh how I thank the stars that at least half of me was well-informed and thinking straight). My Doula-self talked through what a directive such as this would mean, and how it precludes CPR in all circumstances, that it is a legally binding directive that must be obeyed and that it could mean that we might one day have to say goodbye to him rather suddenly. He demonstrated that he understood this, explained why such a directive was the right thing for him and reassured all of us that it was his informed decision.
“I’ve had such a good life, darling” he said, “I don’t need to go through all that, and endure some kind of awful recovery just to buy a bit more time.” I might have cried a little inside, but they were happy tears for him.
An unexpected gift
A couple of weeks later, I discussed the event with my clinical supervisor. She’s a remarkable woman who can hold space so competently that I sometimes wonder if she’d be able to care for all the grieving hearts of this world in one go. I talked about my experience, including both my daughterly reaction and my Doula response.
As we reflected on what had been discussed, we considered how my mother might feel knowing that my father does not wish to have CPR, and why.
“This is a gift you’ve given to your mother,” my supervisor said. “She’ll never have to wonder whether she made the right decision.”
And there it was. An Advance Care Directive isn’t just a legal document or formality— it’s a gift. It’s a gift of empowerment to the person it belongs to, a gift of care from those of us who have helped create it and a gift of peace to those who have to use it. It’s a beautiful, loving, ongoing gift.
