Advance Care Directive and Medical Power of Attorney

Adelaide celebrant Trevor Hayley has written a series about his dad’s final journey, offering practical advice about end of life planning. This blog article, about making an Advance Care Directive and Medical Power of Attorney, is the first in the series.

Dad experienced kidney failure around the age of 70, so dialysis became a part of his weekly journey in his last few years. This started off in the home, but when this got too much he went to a clinic three times a week.

Things were starting to take their toll, and eventually his heart was compromised. There was surgery, which actually fixed the heart. It was unfortunate that the rest of the body could not keep up, including his leg where they took a vein becoming quite an ugly wound. They would give medication for the heart, which would ‘muck up’ the leg and so they would give medication for the leg that would ‘muck up’ the heart.

Dad was in intensive care during this time, so it was only a matter of time for things to come to a head. There had been daily visits for around six months and then the call came from the hospital. Dad had a seizure and was unconscious.

Life had already changed. As Dad would be unable to go back to his unit, care was now needing to step up to alternate living arrangements.

Making decisions about end-of-life medical care

I can still remember the scene. My sister and I looked at each other, and before the doctor came, we knew the time had come. Dialysis was due that evening and we came to the decision that dialysis had now gone from being a life-sustainer to a life support. After speaking with the medical staff about their thoughts, we decided that dialysis would not happen that evening. Ten hours later, with last visits, and surrounded by family, Dad died.

Dad had insisted on putting Medical Powers of Attorney in place. To this day we are not sure whether this document was referred to, but for my sister and I – knowing this was in place – we knew, in our heart of hearts, we could make this difficult decision. Dad trusted us to make this decision on his behalf.

Advance Care Directive

It’s important to note that each state and territory does this a little differently, so you can read more about Living Wills and Medical Power of Attorneys in your state here. Below is some information specific to South Australia only, so please check the details that apply to your state or territory.

Advance Care Directive, South Australia

In South Australia, the document is now called an Advance Care Directive (ACD). It’s a form that prescribes and gives the power over a person’s life and care to one or two ‘Substitute Decision Makers’, which is what my sister and I had become. We could not ask Dad about future dialysis; we had to decide on his behalf.

Just some notes on Advance Care Directives in South Australia. Firstly, they must be on the Government prescribed form, not a typed-up document. Secondly, they are only to deal with your physical care; legal and finances are covered by a Power of Attorney. Thirdly, you must know what you are doing, and a good witness will send family members out of the room to ensure this. And while we are on witnesses, I would encourage you to seek out a Justice of the Peace as the witness, because they usually are trained in what can be a complex document to witness. It is good to know a JP as you do need one from time to time.

Health insurance after a death

Another saving grace with Dad was health insurance. I know it is expensive and we constantly question it, but we did get a statement from our health insurer after his death, and we were very happy to see that the $120,000 that went towards Dad’s hospital care was completely covered. How amazing is that!

I am still grateful, to this day, for the care that Dad received in hospital. I am sure his case was frustrating to the staff, and medically there was a lot going on. But we were always made to feel welcome and those final moments were peaceful.

DAD’S JOURNEY BLOG SERIES

I will continue sharing Dad’s Journey with future posts about his passing. You might also like to read my other articles about How a pre-planned funeral gave Dad the funeral he wanted and  what we did with Dad’s home and belongings after he left us.

The commentary in this blog is intended to be general in nature. It is just some observations from one fellow traveller in life to another. If anything in this blog raises issues for you, please call Lifeline on 13 11 14 or consult with a trusted medical professional. More grief resources can be found in our article Grief counselling and support services in Australia.

About Trevor Hayley

Trevor Hayley was an accountant for 20 years before studying Chaplaincy and Pastoral Care to become a life memorial celebrant, servicing Greater Adelaide, Adelaide Hills, Fleurieu Peninsula, and South Coast. To be in the lives of families, when there has been a loss – a death, is an absolute privilege, Trevor says. To be able to share in the stories and memories of the one who has died; to be able to facilitate a memorable service for families, and to care for them, is at the very core of why Trevor is a celebrant.

Trevor also established Caring Conversations Cafe to practically utilise his skills in grief and loss. Bringing people together in an informal setting, over a coffee, to talk about their grief journey seems to have met a need in the community.

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