Planning for death during a pandemic

By Dr. Ramy Salah

As a palliative care doctor, it is my job to sit with patients and imagine death, the distant reality that we would rather ignore. After warning a heavy conversation is forthcoming, I ask, “Have you thought about how you would want your care to look like if time were short?” The responses to questions about end-of-life care are as varied as they are familiar. “Keep me comfortable.” “I don’t want to be a burden to my children.” “If I can’t recognize my wife, let me go Doc.” Through statements like these, I learn which treatments are most appropriate for my patients on a personal level. It is my goal, after all, to make sure the care that my patients receive matches the care that they would want.

Palliative care focuses on quality of life for patients dealing with serious illness. Therefore, these conversations have become second nature to me. As precise as a surgeon is with her scalpel, I tactfully employ a combination of words and silence to explore my patients’ thoughts about transitions from health to illness, from home to hospital, from life to death. I temper my approach delicately over several visits — as the maxim reads, “Death, like the sun, cannot be looked at steadily.” This is possible with conditions such as cancer or dementia, where life expectancy can be months or even years. During the time of COVID-19, however, we may not have that sort of time.

In the last month, we have been inundated with medical information — I, for one, have tried to decipher more graphs than I would have cared to in a lifetime. From presidential press conferences to cable news to twitter feeds, we eagerly listen for the evidence to make sense of the pandemic. What are the latest numbers of cases and deaths? Which experimental treatments among the antimalarials, antivirals, antibiotics and antibodies seem promising? What are the ethical considerations on rationing ventilators in a national shortage? I am elated that medical professionals have become the loudest voices in the media, however there hasn’t been encouragement for discussions like the ones I have with my patients.

Advance care planning, or better read as “planning for your care in advance,” is generally thought of as a good idea. Though 82% of people say that documenting their wishes regarding end-of-life care is important, only 27% have completed advance directives. My patients are also reluctant to talk about death, but I have seen how much harder it is to have these discussions when they’re critically ill. I say, “In a health crisis you have to process your emotions before making medical decisions. Or you can make those decisions now before things get too emotional.” Studies show that the latter makes for a much smoother process for the patient, their loved ones and their care teams.

So, where do you start? There are three steps in advance care planning:

1). Reflection: Ask yourself — What makes life worth living? What quality of life would be unacceptable for me? There is no shortage of resources to help begin the process, including PREPARE, Go Wish, and The Conversation Project.

2). Conversation: This is the hardest step in the process, and the most crucial. This exercise is useless if you do not share your values and beliefs with those who will be involved in your care if you get sick. This includes your loved ones and your doctors.

3). Documentation: I urge readers to become familiar with two documents: 1). The Advance Directive (AD); and 2). The Physician Orders for Life-Sustaining Treatment (POLST) form. The AD names a durable power of attorney who will make decisions on your behalf if you are unable. It will also direct those involved in your care how to treat you if time were short. The pink POLST form mainly addresses resuscitation — if you were found pulseless, would you want medical personnel to carry out CPR or allow a natural death? I argue that everyone should have an AD, regardless of age or health status. Everyone with a serious medical condition, especially if they reside in a nursing home, should complete a POLST with their doctor.

In the age of coronavirus, I’m sure you, like me, have vacillated between hope and fear. Maybe you shrugged it off as unfounded mass hysteria one day and envisioned doomsday scenarios the next. Regardless, you must translate your energy into positive action. As grateful as I am to you for staying home, practicing good hand hygiene and donating protective equipment to hospitals, I urge you to begin the tough conversations and advance care planning with your loved ones. After all, it’s always too early until it’s too late.

Complete Article HERE!

It’s Time to Talk About Death

The coronavirus pandemic highlights how much we need to have conversations about end-of-life care.

By Sunita Puri, M.D.

Joseph, a man in his 70s, has been on a ventilator for two weeks. His heart, lungs and kidneys are failing. Though I know these facts about his physiology, I will never see him up close. I can only glance at him through clear glass doors, the ventilator and dialysis machine obscuring his face. The coronavirus has limited the number of physicians who can enter his room.

I cannot sit with Joseph’s wife and children to ask what sort of medical care he would want. I cannot read their body language, lean in toward them or offer a tissue as they cry. Now, because of the coronavirus, most hospitals don’t allow families to visit.

Instead, I met Joseph’s wife and children on a Zoom conference call.

“I want to apologize to you for being a face on a screen,” I began. “I wish we could talk about this in person.”

They nodded together, their eyebrows furrowed.

“I wish that I had better news to share,” I said. “Unfortunately, despite our very best efforts to support Joseph’s heart, lungs and kidneys, his body is showing us that he is getting sicker.” I watched, disembodied from a distance, as they hugged each other and cried.

His wife told me that Joseph had never talked with her about what he would want in this sort of situation. “I don’t know what he would say,” she said. “We didn’t think this would ever happen.”

Americans are not good at talking about death. But we need to be prepared for when, not if, illness will strike. The coronavirus is accelerating this need.

In Italy, doctors have had to make excruciating decisions about which patients receive ventilators, which are in short supply. In the United States, we are already facing shortages of life-sustaining therapies; doctors will need to make these same difficult decisions.

Our collective silence about death, suffering and mortality places a tremendous burden on the people we love, and on the doctors and nurses navigating these conversations. We should not be discussing our loved one’s wishes for the first time when they are in an I.C.U. bed, voiceless and pinned in place by machines and tubes.

Talking about death is ultimately talking about life — about who and what matters to us, and how we can live well even when we are dying. Rather than being motivated by fear and anxiety, we can open these discussions from a place of care and concern.

Here’s how I opened a conversation about death with my own parents earlier this month: “Mama, Daddy, seeing a lot of people getting really sick with the coronavirus made me think of both of you. None of us knows what’s around the corner, and I want to be sure I know what you would want for yourselves when you get really sick,” I told them. “I want to be your voice so that I can make decisions for you, not for myself.”

“If I needed a ventilator for a short time, or dialysis, that would be OK, but I would only want treatments that would help me stay independent,” my mother replied.

My father nodded in agreement. “My main hope is to be with all of you. If I will lose my ability to be myself, if my mind will never be clear, please just let God take me,” my father told me, stirring his tea.

Though it is a daunting task, talking about death offers opportunities for grace and connection with our loved ones. Last summer, I watched as a patient’s brother told her for the first time how much he loved her, just before she told him she was choosing hospice instead of a clinical trial. In the fall, I walked the wife of a patient into her husband’s hospital room, where they renewed their wedding vows amid cake, balloons and glittery confetti.

“This was what she always wanted,” he told me when we discussed what was most important to him. “I put it off for so long, but I have to do it before I die.”

Working in the hospital with patients suffering from the coronavirus made me ask myself the questions I hope you will ask yourselves and the people you love:

  • What is most important to me in my life? (My family and pets, and the ability to write and doctor).
  • What makes my life meaningful? (My work; dancing; being outdoors; being with my loved ones).
  • What sort of quality of life would be unacceptable to me? (Being permanently bed-bound or neurologically devastated; indignity and suffering; depending on others for personal care).
  • Who is best positioned to speak on my behalf? (My brother).
  • Who would I not want involved in decision making? (Family living abroad).
  • Would I want to undergo C.P.R. should my heart stop? (Only if the issue leading to the cardiac arrest is reversible. If my heart stopped even when I was being sustained on life support machines or dying from an incurable disease, then I’d prefer to die peacefully rather than with C.P.R.).
  • What would bring me comfort if I were hospitalized? (Pictures of my family; music I love playing in my room; prayer).

This is by no means an exhaustive list of questions. The Conversation Project offers many more, as well as guidance on how and when to begin these conversations. The Serious Illness Conversation Guide gives health care providers a road map of when and how to start asking patients about dying. Both resources offer the compassionate, incisive — and often unfamiliar — language required for us to ask the right questions and empower our loved ones to share specific, honest answers.

Confronting our fears about death — having a conversation about it in frank terms — can be alternately terrifying and tender. Yet knowing how to honor our loved ones’ wishes when they can’t speak for themselves is one of the bravest and most loving things we can do.

Complete Article HERE!

Protecting Trans Bodies in Death

Your life. Your death. Your rights.

***SELECTED SOURCES/ADDITIONAL READING***

“DYING TRANS: PRESERVING IDENTITY IN DEATH” http://www.orderofthegooddeath.com/dy…

“The Supreme Court is finally taking on trans rights. Here’s the woman who started it all.” https://www.vox.com/latest-news/2019/…

“R.G. & G.R. HARRIS FUNERAL HOMES V EEOC & AIMEE STEPHENS” https://www.aclu.org/cases/rg-gr-harr…

“A transgender woman wrote a letter to her boss. It led to her firing — and a trip to the Supreme Court.” https://www.washingtonpost.com/nation…

“Transgender woman dies suddenly, presented at funeral in open casket as a man” https://www.miamiherald.com/news/loca…

“Transgender People Are Misgendered, Even in Death” https://www.vice.com/en_us/article/ex…

Getting Familiar with Life’s Certainty: The D-Word

“I’m gonna die, you’re gonna die. So is everyone we’ve ever loved and hated. And that’s OK.”

By Molly Marco

When I thought about what to write for my End Well blog post, I struggled to think of something different than what I submitted last year. The story I share in last year’s piece is one I’ve now told a million times. I know it well — where to put the emphasis (“Ever onward!”) and what will get the audience’s applause. Conversely, I know what parts of my story people may want to deny or avoid: Death. Dying. Fears and deficits that come with a brain cancer diagnosis.

In July 2016, my brain tumor was discovered after I fainted off a bar stool at a downtown Detroit coffee shop. Turns out, it wasn’t just a simple faint: I had a grade 3 anaplastic astrocytoma. A grade 3 astrocytoma is a junior glioblastoma (or, more accurately, a glioblastoma is a grade 4 astrocytoma). It is incurable and considered a terminal diagnosis, though many patients prefer to call it a chronic illness. That doesn’t mean I’m dying tomorrow — unless, as my neuro-oncologist once told me, I get hit by a car or something like that — it just means we don’t have a fix.

We expect my tumor to, maybe, charge up and for those rogue astrocytes to return — either as anaplastic astrocytoma again, or GBM. One or the other, no lesser. I won’t get better, we just hope that we can hold it off as long as possible before its encore performance. Worse than reoccurrence or GBM? There’s not really anything worse. It’s a turd sandwich.

Though come to think of it, there is worse. Worse is denying that reoccurrence is possible. Worse is convincing myself that I am cured and “cancer-free” (no brain cancer patient should ever be told that falsity) only to crumble and fall to pieces when new growth appears on a future MRI.

After Molly finished her chemotherapy, she got this tattoo. | Memento Mori: Remember you must die. Amor Fati: Love your fate

Worse is not mentally planning for future treatment, including palliative and end-of-life care. When to demand my off-switch to be clicked, so my family isn’t left making the difficult choice for me.

There may come a time when I can’t write and I can’t speak, so I plan to make these decisions while I’m still in control of my think-box.

Losing my mom last year and my aunt recently brings certain things to the forefront of my now with urgency: Death is guaranteed. Death will happen. I want to be ready. Not because I’m morbid or depressed, but the opposite of that. The thought of leaving this world — everyone and everything I love — scares me. The thought of the act of dying scares me more than death itself, to be honest. I need to be on better terms with death and dying.

If death is anything like falling off a barstool and passing out, I can handle that. The thought of an eternal afterlife I can’t even comprehend, but that sounds cool, too. But dying in pain and afraid? That is what I fear. I don’t want that. However, I choose to talk about it so I am as familiar with death and dying as I am with my own name. It’s not because I crave death, it’s because I love being alive with every fiber of my being. I love life so much.

And if we’re honest with ourselves, we can admit that in loving life — truly loving life — we can accept death as a thing we all do. There should be no stigma attached to something absolutely guaranteed from the moment we come into existence: I’m gonna die, you’re gonna die. So is everyone we’ve ever loved and hated. WE ARE ALL GOING TO DIE. That’s that. And that’s OK.

Last year, I suggested we live our best lives and live them right now. This year? Live our best lives, live them right now, because one day — you are going to die. Learn to let it be OK. And be ready.

Complete Article HERE!

How Does a Buddhist Monk Face Death?

If we learn to celebrate life for its ephemeral beauty, its coming and going, we can make peace with its end.

Geshe Dadul Namgyal

By George Yancy

This is the first in a series of interviews with religious scholars from several faiths — and one atheist — on the meaning of death. This month’s conversation is with Geshe Dadul Namgyal, a Tibetan Buddhist monk who began his Buddhist studies in 1977 at the Institute of Buddhist Dialectics in Dharamsala, India, and went on to earn the prestigious Geshe Lharampa degree in 1992 at Drepung Loseling Monastic University, South India. He also holds a master’s degree in English Literature from Panjab University, Chandigarh, India. He is currently with the Center for Contemplative Science and Compassion-Based Ethics, Emory University. This interview was conducted by email. — George Yancy

George Yancy: I was about 20 years old when I first became intrigued by Eastern thought, especially Buddhism. It was the transformation of Siddhartha Gautama to the Buddha that fascinated me, especially the sense of calmness when faced with competing desires and fears. For so many, death is one of those fears. Can you say why, from a Buddhist perspective, we humans fear death?

Dadul Namgyal: We fear death because we love life, but a little too much, and often look at just the preferred side of it. That is, we cling to a fantasized life, seeing it with colors brighter than it has. Particularly, we insist on seeing life in its incomplete form without death, its inalienable flip side. It’s not that we think death will not come someday, but that it will not happen today, tomorrow, next month, next year, and so on. This biased, selective and incomplete image of life gradually builds in us a strong wish, hope, or even belief in a life with no death associated with it, at least in the foreseeable future. However, reality contradicts this belief. So it is natural for us, as long as we succumb to those inner fragilities, to have this fear of death, to not want to think of it or see it as something that will rip life apart.

We fear death also because we are attached to our comforts of wealth, family, friends, power, and other worldly pleasures. We see death as something that would separate us from the objects to which we cling. In addition, we fear death because of our uncertainty about what follows it. A sense of being not in control, but at the mercy of circumstance, contributes to the fear. It is important to note that fear of death is not the same as knowledge or awareness of death.

Yancy: You point out that most of us embrace life, but fail or refuse to see that death is part of the existential cards dealt, so to speak. It would seem then that our failure to accept the link between life and death is at the root of this fear.

Namgyal: Yes, it is. We fail to see and accept reality as it is — with life in death and death in life. In addition, the habits of self-obsession, the attitude of self-importance and the insistence on a distinct self-identity separate us from the whole of which we are an inalienable part.

Yancy: I really like how you link the idea of self-centeredness with our fear of death. It would seem that part of dealing with death is getting out of the way of ourselves, which is linked, I imagine, to ways of facing death with a peaceful mind.

Namgyal: We can reflect on and contemplate the inevitability of death, and learn to accept it as a part of the gift of life. If we learn to celebrate life for its ephemeral beauty, its coming and going, appearance and disappearance, we can come to terms with and make peace with it. We will then appreciate its message of being in a constant process of renewal and regeneration without holding back, like everything and with everything, including the mountains, stars, and even the universe itself undergoing continual change and renewal. This points to the possibility of being at ease with and accepting the fact of constant change, while at the same time making the most sensible and selfless use of the present moment.

Yancy: That is a beautiful description. Can you say more about how we achieve a peaceful mind?

Namgyal: Try first to gain an unmistaken recognition of what disturbs your mental stability, how those elements of disturbance operate and what fuels them. Then, wonder if something can be done to address them. If the answer to this is no, then what other option do you have than to endure this with acceptance? There is no use for worrying. If, on the other hand, the answer is yes, you may seek those methods and apply them. Again, there is no need for worry.

Obviously, some ways to calm and quiet the mind at the outset will come in handy. Based on that stability or calmness, above all, deepen the insight into the ways things are connected and mutually affect one another, both in negative and positive senses, and integrate them accordingly into your life. We should recognize the destructive elements within us — our afflictive emotions and distorted perspectives — and understand them thoroughly. When do they arise? What measures would counteract them? We should also understand the constructive elements or their potentials within us and strive to learn ways to tap them and enhance them.

Yancy: What do you think that we lose when we fail to look at death for what it is?

Namgyal: When we fail to look at death for what it is — as an inseparable part of life — and do not live our lives accordingly, our thoughts and actions become disconnected from reality and full of conflicting elements, which create unnecessary friction in their wake. We could mess up this wondrous gift or else settle for very shortsighted goals and trivial purposes, which would ultimately mean nothing to us. Eventually we would meet death as though we have never lived in the first place, with no clue as to what life is and how to deal with it.

Yancy: I’m curious about what you called the “gift of life.” In what way is life a gift? And given the link that you’ve described between death and life, might death also be a kind of gift?

Namgyal: I spoke of life as a gift because this is what almost all of us agree on without any second thought, though we may differ in exactly what that gift means for each one of us. I meant to use it as an anchor, a starting point for appreciating life in its wholeness, with death being an inalienable part of it.

Death, as it naturally occurs, is part of that gift, and together with life makes this thing called existence whole, complete and meaningful. In fact, it is our imminent end that gives life much of its sense of value and purpose. Death also represents renewal, regeneration and continuity, and contemplating it in the proper light imbues us with the transformative qualities of understanding, acceptance, tolerance, hope, responsibility, and generosity. In one of the sutras, the Buddha extols meditation on death as the supreme meditation.

Yancy: You also said that we fear death because of our uncertainty about what follows it. As you know, in Plato’s “Apology,” Socrates suggests that death is a kind of blessing that involves either a “dreamless sleep” or the transmigration of the soul to another place. As a Tibetan Buddhist, do you believe that there is anything after death?

Namgyal: In the Buddhist tradition, particularly at the Vajrayana level, we believe in the continuity of subtle mind and subtle energy into the next life, and the next after that, and so on without end. This subtle mind-energy is eternal; it knows no creation or destruction. For us ordinary beings, this way of transitioning into a new life happens not by choice but under the influence of our past virtuous and non-virtuous actions. This includes the possibility of being born into many forms of life.

Yancy: As a child I would incessantly ask my mother about a possible afterlife. What might we tell our children when they express fear of the afterlife?

Namgyal: We might tell them that an afterlife would be a continuation of themselves, and that their actions in this life, either good or bad, will bear fruit. So if they cultivate compassion and insight in this life by training in positive thinking and properly relating to others, then one would carry those qualities and their potential into the next. They would help them take every situation, including death itself, in stride. So, the sure way to address fear of the afterlife is to live the present life compassionately and wisely which, by the way, also helps us have a happy and meaningful life in the present.

Complete Article HERE!

I’m Going to Die.

I May as Well Be Cheerful About It.

By Mary Pipher

While death is inevitable, our attitude about it is not.

Generally, I don’t think about death during the day. My schedule is full, and I focus on what is right before my eyes. It’s usually only when I go to funerals that I reflect upon deaths past, present and future; most of the time I think about life. Still, about once a month I wake in the night and know with absolute clarity that I will soon be gone.

I have always felt my own finitude. My father had his first stroke at 45 and died at 54. My mother died of diabetes at 74. I am 72. I would like to attend my last grandchild’s high school graduation and meet at least one great-grandchild. However, with my family history, that is unlikely. Now, with the news filled with stories of the coronavirus, I am reminded of the many random diseases that can strike suddenly and lethally.

Like almost all my peers, I want to die young as late as possible. I don’t want to live beyond my energy level. I don’t want to suffer dementia or lie helpless in a hospital. I want to die while I still believe that others love me and that I am useful.

I have done what I can to prepare for my death. I have a will, a health care proxy and medical directives. I’ve had many conversations with my family and my doctor about end-of-life decisions. My mnemonic device for all of them is, “If in doubt, snuff me out.”

While death is inevitable, our attitudes about it are not. We can be sanguine or gloomy, solicitous of others or self-absorbed. We can approach our deaths with fear and resistance or with curiosity and a sense of mission.

Facing death offers us an opportunity to work with everything we have within us and everything we know about the world. If we have been resilient most of our lives, most likely we will cope well with our own dying. It is frightening, of course, but it is our last chance to be a role model, even a hero.

I’d like to face death with the courage of my grandmother. The last time I visited her, she was recently widowed and dying from leukemia. She lay in bed in her small home in eastern Colorado. I could see she was in pain and could barely move, but when I asked about her health, she replied: “Let’s talk about you. How is college going this year?”

When I complimented her on her courage, she said simply, “I am going to be in pain and die soon no matter how I behave, so I might as well be cheerful.”

By the time we are in our 70s, we are likely to have witnessed many people dying. I’ve seen my parents and my husband’s parents die “bad deaths” with months of suffering and too much medical intervention, and I’ve witnessed peaceful deaths in rooms filled with love. Most of us boomers know how to behave at a bedside and have a sense of how we want to act when it’s our turn to be the one in bed.

We also have had decades of observing the rituals of death — hospitals and hospice, funerals, burials and the communal meals afterward. From these experiences, we have learned what we do and don’t want when it’s our turn. We may continue some of these traditions, but we will also design our own. Some of my friends with terminal illnesses have hosted goodbye parties in parks or at our local blues bar. Wakes with dancing, music and storytelling are back in style. Many of us want pine box coffins, green burials or cremations with our ashes tossed in beautiful places.

What happens after death is a popular topic among people I know. Opinions range from, “We turn into dirt,” to “I will see the face of God.” My writer friends want heaven to have a good library. One friend believes we will return to the place we were before we were born.

Jean Nordhaus wrote, “The dead are all around us / feathering the air with their wings.” A therapist who lost her young, cello-playing husband told me she feels his presence and knows they are still deeply connected in spirit. She finds that many people are afraid to die because they have no language for the numinous; however, she is certain that neither life nor relationships end with death.

I feel death may not be as big a change as we suppose. Rather, it might be like crossing a river.

I like to think that my relatives and friends will be waiting for me on the other side. I like to imagine grassy banks and flower-filled pastures shining in the sun. I like to think a lot of things, but I don’t know for sure.

I am not a particularly mystical person, but I have had mystifying experiences. When my Aunt Grace died, I drove to the Ozarks for her funeral. Her little house was surrounded by pink surprise lilies — what my cousins called “naked ladies.” The next spring, even though I had not planted them and they had never come up before, surprise lilies popped up in my garden. The year after that they popped up again but in different places. I concluded that Aunt Grace was greeting me. If I wanted to send a message after death, I would do it with flowers, too.

I love the world but I cannot stay. Death is democratic and we will all participate in its enactment. I will miss the beauty all around me. I have taken so much pleasure in the natural world, in people and books, in music and art, in cups of coffee and lolling cats. If I knew that I had a month left to live, I wouldn’t spend my time much differently than I do now.

All of my life I have loved snow.

When I was a girl in the 1950s, snow fell often in the long winters of western Nebraska. I remember one winter when, after the streets were plowed, mountains of snow 10 feet tall stood in the middle of the streets. As a young mother, my favorite days were snow days when our family could stay home and play board games. I would make soup and popcorn. I relished taking my children outside to do the things that I had done in the snow as a girl. I loved falling asleep with my family safe on a blizzardy night when the streets were impassable and a blanket of peace covered our town.

Now, snow has become a profoundly spiritual experience. When it snows, I sit by my window and watch it fall. I go deep into its purity and softness.

Snow falls inside and outside of me. It settles my brain and calms my body.

I hope death feels like watching the snow grow thicker and thicker. Doctors call dying of a morphine overdose being “snowed.” I would not mind that at all. I would like to disappear in a whiteout.

Complete Article HERE!

Love is not enough for end of life decisions…

This ground breaking video is challenging the commonly held perception that a loving relationship is all you need to ensure your end-of life wishes will be met.

The launch of the video is timed to stimulate interest and discussion in the lead up to the third annual, National Advance Care Planning Week, 23 – 27 March, an initiative led by Advance Care Planning Australia (ACPA), with funding from the Australian Government.

Produced by the award-winning Creativa video production agency, the Love is Not Enough video introduces two couples and one father and daughter, testing how well they know their loved one. While they were mostly able to correctly answer questions about preferred foods and holiday destinations, when it came to questions about end-of-life treatments they were less sure.

Interviewees were confronted with tough hypothetical treatment decisions for their loved ones including whether they would accept tube feeding following a stroke or extend their cancer treatment if it meant never leaving hospital.

This discrepancy is backed up by research[1]that shows that the people closest to us often don’t know our end-of-life wishes unless we expressly have the conversation or write our preferences in an Advance Care Directive.

“We created this video to shine a light on the fact that even with those closest to us, it is wrong to assume they would know our preferences for end-of-life care,” explains ACPA Program Director, Linda Nolte.

“While the questions posed in the video may seem confronting, these real-life scenarios play out every day in hospitals across Australia. It’s a terrible burden for families to bear having to blindly make life and death decisions, without knowing their loved one’s preferences. A simple discussion today can save a lot of heartache tomorrow.

“Despite legislative and policy support for advance care planning across Australia, public understanding and uptake remains low. People need to know that a loving relationship is no substitute for advance care planning. The person closest to you may not be the best choice to make decisions for you if you become too unwell to speak for yourself.

“With National Advance Care Planning Week coming up, it’s an opportunity for all of us to consider our future medical care, whether it’s attending an event or having a chat with loved ones. I urge all Australians to join us and find out more,” says Ms Nolte.