A Good Life
Some time ago I read Being Mortal by Atul Gawande. It’s an astonishing book and one I urge you to read. Anyway, having a good life for as long as I can is important to me, so the issues this book raises about life before death resonated. Both with me on a personal level and with me as a Will writer. For instance, if you’re told you have a terminal illness how would you cope? How would your family manage? When you get to the actual end – what matters the most to you? Are you willing to make trade-offs to prolong your life? How do you want to spend your last year, months, or days? These are deep questions. These are important questions. But yet few people give them any consideration until they’ve got no choice.
Football and Chocolate
Gawande is a USA-based surgeon. In his book, he talks of long-term care for the elderly and of aggressive treatment of diseases. The main thrust of his discussion centres on what matters the most to those with terminal illnesses. He reports on research showing how hospice care, received at home, often results in patients living longer, in less pain, and with more dignity than those who receive aggressive and invasive treatments. Of course, this is a generalisation – so much depends on a patient’s individual circumstances. In the book, Gawande discusses the right questions to ask patients faced with the knowledge of their impending, premature death. He explains the importance of finding out what the person understands about their illness. Further, what steps they want to take and what, if any, trade-offs they’re prepared to make.
One example he uses is that of someone with a terminal illness. He uses this scenario to show how such a patient must decide if wants to go through with a risky operation. This operation could leave him paralysed from the neck down if not successful. But if it does work he faces a good chance of prolonged life for several years. In this example scenario, the patient concerned has already spoken to his daughter. He’s told her that, so long as he can watch American football on TV and eat chocolate ice cream then life is worth living.
The inevitable occurs, the operation has complications, and the doctors ask the daughter should they carry on. Remembering her father’s words she asks can her dad still watch football on TV and eat chocolate ice cream if they carry on. ‘Yes’, say the doctors. So she tells them to proceed. Her father lives for several more years, paralysed as predicted, but living a life worth living for him. Isn’t this a super simple way to make a massive decision? In speaking beforehand about what matters, this man’s daughter could assess the risks and decide for him.
When the end is nigh – what matters most to you?
When I’m not writing Wills I’m drafting Lasting Powers of Attorney for client’s health and welfare. Now many people that I encounter worry about such LPOAs. They worry that having this kind of LPOA in place would allow relatives to make important decisions about their long-term care, on their behalf and without them having any say in the matter. But you mustn’t fear that. Whoever has these attorney powers can only use them if you no longer have the mental capacity to make such a decision. But it’s such an important safeguard to have in place should such a situation arise.
When I’m drafting an LPOA I make a point of asking clients if they’ve discussed decisions about end-of-life care with their attorneys. Your attorneys tend to be spouses, children, or other close family members.
It ought to be natural to talk about such things with loved ones but it isn’t. And that’s a great sadness. I know I want my family to know my wishes, wants, and needs. Armed with that information they can help me to live the life I want for as long as possible. Being able to enjoy chocolate is a definite for me! Aside from chocolate, I want to receive home care rather than being in a residential care home. They’re aware of all this – so they can argue for it.
If you’ve got any questions about Lasting Power of Attorney or Wills of course you can drop me a message via my webform here. Or if you prefer, ring me on: 07538 946839.
BACK TO THE BOOK – A BOOK FOR ALL AGES
As I said at the top of this blog, I do urge you all to read Being Mortal by Atul Gawande. It’s easy to read, it’s funny and it’s important. We need to be so much more open about matters of a good life and about death.
It’s relevant to everyone because it discusses stuff that matters to everyone. I trust it’ll help you talk to your family about what matters most to you. If you read it – let me know what you think. I’d love to hear about it.