Elvenia Gray-Sandiford
According to a recent survey by the National Hospice Organization, an impressive nine in 10 people stated their wish to receive end-of-life care in the comfort of their own homes if they were terminally ill.
The longing for familiar surroundings and solace during such a vulnerable period is relatable, and profoundly human. Despite these heartfelt desires, data from the New England Journal of Medicine paints a harsh reality: over half of Americans (along with Canadians) and individuals in various countries ultimately pass away in hospitals or institutional settings such as nursing homes.
The mismatch between individual preferences and actual end-of-life experiences raises the question: why do so many people not have the chance to spend their final moments in the warmth of their own homes? The answer is a complex mix of societal norms, and systemic obstacles to end-of-life planning and care.
A significant factor contributing to this discrepancy is the absence of thorough end-of-life planning. While many express the wish to die at home, a notable portion of individuals lack formalized arrangements to ensure their desires are respected. Advance directives, like living wills and health care proxies, are essential tools for outlining one’s medical care preferences, along with appointing a trusted person to make decisions on their behalf if they are unable.
Interestingly, 87 per cent of people recognize the significance of these documents, but only a small fraction have completed them. Among those who have, half confess to not knowing the location of these important papers. This underscores a critical readiness gap and emphasizes the urgency of proactive end-of-life planning.
Another factor contributing to the gap between end-of-life wishes and realities is the pervasive fear and avoidance associated with death. Death, once a natural part of life, has become increasingly medicalized and separated from everyday experiences in the past century. This medicalization has led to a culture of fear and avoidance, making conversations about end-of-life preferences, and planning for them, uncomfortable for many.
Both men and women should actively participate in discussions about their end-of-life preferences. Moreover, there is a critical need for education and awareness initiatives to normalize discussions about death and empower individuals to make informed choices about their care.
Some practical tips and resources for individuals to start their end-of-life planning:
- Create an advance directive: An advance directive is a legal document that outlines your medical care preferences in case you cannot communicate them yourself. It typically includes a living will and a health care proxy. You can consult with an attorney or use online resources to create one.
- Discuss your wishes with loved ones: Have open and honest conversations with your family and loved ones about your end-of-life preferences. This can help ensure that your wishes are known and respected.
- Document important information: Make sure your important documents, such as your advance directive, will, and insurance information, are easily accessible to your loved ones in case of an emergency.
- Consider financial planning: Review your financial situation and consider setting aside funds for end-of-life care or funeral expenses. You may also want to consider purchasing long-term care insurance.
- Seek counseling or support: If you feel overwhelmed or unsure about how to start your end-of-life planning, consider seeking support from a loved one, social worker, or end-of-life planning specialist.
- Explore community resources: Many communities offer resources and workshops on end-of-life planning. Look for local organizations or hospice agencies that can provide guidance and support. The Ashcroft and District Hospice Society is an excellent resource: visit their website at www.ashcroftdistricthospicesociety.org.
Remember, starting end-of-life planning can feel daunting, but through having hard, open conversations, and promoting proactive end-of-life preparations, we can strive towards a more empathetic and respectful approach to end-of-life care for everyone. Taking small steps now can help ensure that your wishes are honoured, and ease the burden on your loved ones during a difficult time.
