Knowing what matters to your loved one helps with medical decisions

• When your loved one isn’t well enough to make a medical decision, you may be called upon to help.
• It’s impossible to list every possible event and what choice your loved one would make in that event.
• Knowing what matters most to them can help you make decisions that reflect your loved one’s values and priorities.
• If you have a life-limiting illness, tell your loved ones what your priorities are.

Advance Care Planning is simply the process of thinking ahead and letting people know about how you want end of life or life-sustaining care decisions to be made. It's hard to list every possible event and what your choice in that event would be. Instead, we tell people what matters the most to us: what's really important? Then, when a decision must be made and we're not well enough to make it, our Attorneys or loved ones can tell the professional who must make that decision what matters most to us. The medical decision then reflects our personal values.

For example, let's imagine a person who has been living with a long-term health condition for years. They are weary and unsure how much longer they will relish living. They may think having the best possible quality of life matters more than living another decade. Quality, rather than length of life, is their priority. Let's call them Sam.

Let's imagine another person in the same circumstances up until now, but who heard last week that their first grandchild will be born in 6 months. They are desperate to meet that baby! Last week, they would have said quality of life was their priority; this week, living to meet the baby is more important. Let's call them Lou.

Of course, we all have lots of priorities, so maybe these two imaginary people have priorities that include seeing their family often, or being well enough to read their newspaper or listen to a favourite radio programme. Now imagine they had a sudden medical event, and there were options for life-sustaining treatment using a ventilator in an Intensive Care Unit (ICU,  with a 50-50 chance they would survive and an 80-20 chance they would no longer be well enough to live their current lifestyle. In this situation, their doctors would want to know whether Sam and Lou would accept that ventilator offer.

Can you see where this is going? Neither Sam nor Lou has ever had a discussion with their loved ones about ventilators. But they have been very clear about their priorities. 

Whatever your values and beliefs, it’s important to discuss these with someone. And to keep that conversation going. Here are some resources that might help:

• Advance Care Planning Australia 
• My Values 

With The End in Mind by Dr Kathryn Mannix