Case Study: Ensuring Your Final Wishes Are Honoured
© Danielle Robertson Consulting Pty Ltd t/as DR Care Solutions
As I said in a recent blog, 'Being Diagnosed With A Terminal Illness: What Comes Next?', if you have been diagnosed with a terminal illness, it is important to start planning to ensure your final days are lived in accordance with your wishes.
Your planning may not only relieve you of unnecessary emotional and physical suffering, it will help reduce the grief and stress experienced by your loved ones.
Get on with your planning as soon as possible and don’t be left seeking arrangements at the last minute, like my client Bob*.
After a fall, Bob found himself in hospital and, after a thorough examination, was diagnosed with terminal cancer. The cancer he had fought 10 years prior had now taken over.
Bob was given one month to live and it turned out to be six weeks. I was called in one week before his final day, and despite our best efforts, his final wish to die at home was not honoured. Bob died in hospital.
A former formidable businessman, and true to form, Bob had meticulously arranged his paperwork well in advance – the Will, the Advance Care Directive (also known as Advance Health Directive in some States / Territories), the Power of Attorney, the Enduring Guardianship, an investment register, a password register, and notice to his lawyer, accountant, bank and financial adviser!
There was one matter however that was left to the final week, and that was Bob’s fierce desire to die at home and not in his hospital bed. I was engaged to move Bob back home.
The Care Solution
Moving a terminally ill patient from a hospital or residential care setting to their home for end-of-life care can take time. The more extensive the care requirements, the longer it takes. Arranging end of life care in the home for Bob took five days.
In that time DR Care Solutions:
- Met with Bob to discuss his final wishes.
- Arranged multiple family meetings, via conference calls, to keep them informed and provide support.
- Set up in the home a palliative care team of five quality nurses and care staff to provide 24/7 care.
- Arranged the daily visiting schedule of the government-funded and hospital-based, Community Palliative Care team, to check on the giving of medications, in particular the administering of morphine.
- Undertook a risk assessment of the home and arranged the delivery of supporting equipment, including a new bed, air mattress, commode, chair and shower chair.
- Organised a social worker to provide grief counselling to Bob’s spouse and four children.
- Diarised visits, in accordance with Bob’s wishes, of his local Anglican minister.
While everything at home was ready, on the day Bob was to return home his oncologist advised against it. Bob passed away peacefully that afternoon in hospital with his family by his side.
Life expectancy estimates
When giving a terminally ill patient guidance on how long they have to live, doctors use their experience, clinical judgement, and empirical data on life expectancies of patients in similar situations.
It is not an exact science and, like many things in life, there's a bell-shaped curve which sees some patients do far worse or far better than the estimate.
Doctors give estimates of life expectancy to give patients and family members a rough guideline and an opportunity for them to make the right medical and personal decisions.
My advice is to start planning early and well before you have a life event. Implement the plan for your end of life when you are first diagnosed and revisit that plan when your life expectancy comes down to a matter of months.
To help with your planning, tick off the items in the DR Care Solutions End-of-Life Planning Checklist which you can download here:
*Names have been changed to protect the identity and privacy of the client.
For guidance on end of life planning, reach out to Danielle Robertson at DR Care Solutions for an initial discussion on how to set up the right care, support and assistance for yourself or a loved one at the right time and in the right place.