End of Life Plans
An end of life plan is a way of recording what matters to you and what you would like to happen as you approach the end of your life.
It is not just about your funeral. It can include your wishes about your health care, where you would like to be cared for, who you want involved, what matters to you when you are dying and what you would like to happen after you die.
The aim is simple: make your wishes known while you are able to do so.
Why Make an End of Life Plan?
We often think of end of life planning as something that happens when someone is already dying. It doesn’t have to be.
You might be fit and healthy. You might be getting older. You might have received a life-limiting diagnosis. Or you might simply want to make things easier for the people who may one day need to speak for you.
Having a plan means that the people around you do not have to guess what you would have wanted.
It can also give you the opportunity to have conversations that are difficult to have once a crisis has already arrived.
What Can Be Included?
There is no single right way to make an end of life plan.
You might want to think about:
- Your health care --- what treatments would you want or not want if you could no longer make decisions yourself?
- Where you would like to be cared for --- if circumstances allow, would you prefer to remain at home, be in a hospital, or receive care somewhere else?
- Who you want involved --- who should be part of conversations about your care?
- What is important to you --- family, friends, pets, music, particular places, cultural, religious or spiritual practices, or simply being comfortable and surrounded by people you trust.
- What worries you --- perhaps there are things about dying or becoming unable to make decisions that you particularly want your carers or family to understand.
- Your funeral or farewell --- cremation or burial, whether you want a service, where you would like it to happen and who you would like involved.
- Practical matters --- important documents, contacts and other information that will help the people around you know what to do.
You don’t have to answer every question. Start with the things that matter most to you.
An Advance Health Directive
In Queensland, an Advance Health Directive is a legal document that allows you to give directions about your future health care and special health care.
The Queensland Advance Health Directive also allows you to appoint an attorney for health matters. Your directions only operate when you do not have capacity to make the relevant health care decision.
The Queensland form asks you to consider more than just medical treatment. It includes space for your views, wishes and preferences, including what is important to you, what worries you about the future, cultural, religious or spiritual values, and what would be important or comforting when you are nearing death.
You can also give specific directions about life-sustaining treatment and other health care.
The Queensland form requires a doctor to complete the doctor certificate and an eligible witness to witness the document. The completed document should be kept safely, with copies provided to the people who may need it, including your doctor and any attorney you have appointed.
An Advance Health Directive is one part of an end of life plan. It does not need to contain everything you want your family or friends to know.
A Statement of Choices
A Statement of Choices is a Queensland advance care planning document that records your values, wishes and preferences about your future health care.
Unlike an Advance Health Directive,
a Statement of Choices is not a legal document.
It does not give consent to, or refuse, particular medical treatment. Instead, it helps the people who may need to make decisions for you understand what matters to you and what you would want.
It can include things such as what is important to you, your preferences about medical treatment and life-sustaining measures, where you would prefer to be cared for, and who you would like involved in decisions about your care.
A Statement of Choices can be useful alongside an Advance Health Directive. The two documents serve different purposes: an Advance Health Directive provides legally binding directions about certain health care decisions, while a Statement of Choices provides a broader picture of your values and preferences.
You don’t have to wait until you are seriously ill to complete one. It can be part of a broader end of life plan, helping your family, friends and health care providers understand what matters to you if you are no longer able to tell them yourself.
What About the Things That Aren’t Legal Documents?
Some of the most important parts of an end of life plan are simply conversations and written notes.
You might write down:
These things may not be formal legal directions, but they can help the people around you understand what matters to you.
Your plan can also change. What matters to you at 40 may not be what matters to you at 80, or after a major change in your health.
You Don’t Have to Have Family to Make a Plan
Some people have a large and supportive family. Others don’t.
You may live alone, have no children, have family who live a long way away, be estranged from relatives, or simply not want to place all of this responsibility on your family.
That does not mean you cannot plan.
An End of Life Doula can sometimes be helpful in this situation. Their role is non-medical and non-clinical, but they can provide time, information, practical help, companionship and continuity. They may help you explore what matters to you, have difficult conversations, document your wishes and make practical arrangements.
An end of life doula can be particularly valuable for someone with limited family support because they can become a consistent person who understands the individual’s wishes and can help support those wishes alongside the appropriate health and care professionals.
A doula does not replace a doctor, nurse, palliative care team or legally appointed decision-maker. The roles are different, but they can work alongside each other.
Planning Your Funeral
Your funeral is only one part of an end of life plan, but it is often one of the easier things to talk about.
You can decide as much or as little as you like.
You might want:
- a simple cremation with no service
- a funeral with the person present
- a memorial after cremation
- a burial
- a family gathering at home
- a farewell somewhere meaningful
- something completely different.
There is no requirement for your funeral to look like someone else’s.
Writing down your wishes can make things much easier for the people left behind. They won’t have to wonder whether you would have preferred burial or cremation, whether you wanted a service, or whether there was somewhere special where you wanted people to gather.
If you want to go further, you can also arrange and pay for your funeral in advance. A pre-paid funeral contract and funeral bond are one way of doing this. See Funeral Bonds for more information.
Keep It Somewhere People Can Find It
A plan is only useful if the people who need it know that it exists.
The Queensland Advance Health Directive recommends keeping the original in a safe place and giving copies to relevant people such as your doctor, health providers, attorney or lawyer. It also recommends telling close family and friends that you have made one and where it can be found.
The same principle applies to the rest of your end of life plan.
Tell someone where you have kept it.
You might also keep a simple list of important contacts and documents with it.
Start Small
You don’t need to sit down and plan your entire death in one afternoon.
Start with one question:
What would I want the people around me to know if I could no longer tell them myself?
Write down the answer.
Then perhaps have the conversation with someone you trust.
An end of life plan is not about predicting exactly how you will die. It is about giving the people around you some understanding of who you are, what matters to you and what you would like when the time comes.
You don’t have to plan everything. You just have to start the conversation.