Advance Care Planning for health care decisions

"What would you do if something happened to you and you were unable to communicate with others?"

(L-r) Medical student Sachiko Takahashi

(L-r) Medical student Sachiko Takahashi

“Bad things happen,” said Dr. John Soles. “What would you do if something happened to you and you were unable to communicate with others?”

The local physician made the statement and asked the question during an introduction to a workshop about Advance Care Planning held June 9 in the Pit at Clearwater Secondary School.

About 30 members of the public listened as a dozen expert panelists discussed how to plan for what should happen when a person is no longer able to tell other people his or her wishes.

The most important document to have prepared before a crisis is a will, said lawyer Jim McCreight. Many people don’t have a will or if they do, it’s out of date.

Other documents to consider include a power of attorney, which allows someone else to act on a person’s behalf in financial matters, and a representation agreement, which gives the power to speak on a person’s behalf in healthcare issues.

“More and more these days, the power of attorney and representation agreement go hand-in-hand,” McCreight said.

Financial institutions such as credit unions can help with all aspects of estate and other financial planning, said Gina Walchuk, manager of the Clearwater ISCU.

“There’s never a good time to bring these things up, but during a crisis is the worst time,” she said.

Royal Bank also can help its clients with advice, said representative Eva McLeod.

This can include cash flow planning, preserving assets and gifting … “Giving with a warm hand instead of a cold hand,” she said.

There are a wide variety of services offered in Clearwater for those having difficulty or unable to care for themselves, said Kym Baresinkoff, nursing care leader at Dr. Helmcken Memorial Hospital.

For example, if a person staying at home needs a nurse to visit, there is no charge unless special dressings are required.

Other programs include rehabilitation or physiotherapy in the home, home support, in-home respite, adult day services, and palliative care. She noted that two beds are kept in Forestview Place for temporary stays so home caregivers can have a respite.

“Most elderly people prefer to be at home and independent,” said Baresinkoff.

Pain management and palliative care are important aspects of health care, said Sachiko Takahashi, a third year medical student visiting Clearwater under the inter-professional rural program of B.C. (IPRBC).

There are a number of myths associated with pain medication, she said. For example, only a small percentage of terminally ill patients become addicted to pain drugs, according to the medical student.

An expected death at home should be planned for, said Kiah Dundas, a third year nursing student with IPRBC. There is a form at the Ministry of Health website that can help.

Even though there is a long list of people waiting for an organ transplant, only a small percentage of British Columbians become donors, said Alyssa Roerslev, a fourth year social work student with IPRBC.

It is possible to register as a donor online at the Transplant BC website, she said. The stickers formerly attached to driver’s licenses no longer apply.

Members of the local hospice society are devoted to the care of the terminally ill, said Andrea Lenny, volunteer coordinator.

“We are a shoulder to cry on and a hand to hold for you and your family,” she said.

Usually a doctor refers clients to the society but they also can call directly.

Spiritual needs should be included in any advanced care planning, advised Lloyd Strickland of Clearwater Christian Church.

“A person’s spirituality can help a person through the last days of life,” he said. “Seek out those who can be with you in difficult times.”

Drake Smith listed four things that should be considered. First, get a will. Second, pre-arrange your funeral. Third, be aware you can transfer your pre-arrangements to another funeral home – even after death. The North Thompson Funeral Home director’s fourth point was to be aware that, if the death of a loved one occurs anywhere in B.C. and if it benefits you, arrangements can be made from Clearwater.

Social worker Lynda Myers reported that a number of changes in the laws affecting advance care planning will come into effect as of Sept. 1.

The changes will give more choices and options to people as well as providing more safeguards and protection.

She gave as an example the present inability of in-laws to make healthcare decisions. This will be allowed under the new rules.

“We often see people who say the trauma of working through the complications was almost as difficult as the loss itself,” said Berni Easson, health services manager at Dr. Helmcken Memorial Hospital.

She said a workbook titled “My Voice” from Interior Health provides much information, asks the right questions and is well-respected by those in the hospital community.

Easson said about 30 people in Clearwater and area have been trained as advance care planning facilitators.