Thread by @drkathrynmannix

What do we need to know now, to protect the wishes of our loved ones at the end of their lives?
Great question @tdeweymarn @DrMariMcV
I feel a thread coming on...

https://twitter.com/tdeweymarn/status/1232433899839442947

Before you start, remember this conversation is theirs as much as yours:
- invite, don't compel.
- give them options about when to have this conversation, where to have it, how long to give it
-have a plan for after the chat: cuppa, favourite TV show, walk, hobby etc

There are some things that seem huge, but can be surprisingly simple.
There are some apparently trivial things that can assume huge proportions later on.
These can vary from family to family.
If it feels delicate, ask if it's ok to continue.

In some parts of the world, we can be legally appointed to represent someone's views & to decline treatments on their behalf. For the UK find out more here: compassionindying.org.uk/making-decisio…
A health/welfare Attorney needs to know those views - don't accept role but duck the discussion!

Whether or not the person wishes to appoint an Attorney, it's very helpful to understand the way they view particular things so that, if necessary in the future, we can help a decision-maker to understand the person's life-view.

If you were so sick that you might die, would you want to take your chances & stay out of hospital? Have the most treatment possible, drips, ventilator, tube-feeding? Or somewhere in between? For example, give hospital a chance to save your life, but if death is likely, go home?

If death seems to be approaching, would you prefer treatments aimed at comfort, even if they may make you sleepy? Or would you prioritise sharp thinking, even if that meant putting up with some discomfort?
Do you have any preferences about where you are looked after?

Are there any treatments that you definitely don't want? CPR, ventilator, tube-feeding, blood transfusions, other things? Consider making an Advance Decision to Refuse Treatment, noting the specific circumstances in which you would refuse the treatment.

Wording is important in an ADRT. If you would refuse the treatment even if that means you might/would die, then you must state that.
More info and an easy to complete ADRT that complies with UK law at @AGoodDeath (as above in this thread).

Who are the people who should be around you if they can be, towards the end of your life?
Do you have wishes about access to people outside your family for support? Who are your important friends? How can they be contacted? Do you want them to visit, or just to be kept informed?

Who is relying on you? Do you have dependents? Pets? Someone you regularly support with visits, letters or phone calls? How should this be managed if you become too unwell, temporarily or permanently, to maintain those tasks?

What brings you joy?
If you are stuck in bed, what music, news, nature, books, people, pets etc would you like access to?
(For the record: I'm a talk radio person. Don't play your music at me!)
What perfumes & aromas do you love or dislike?

How important to you is it to look groomed? How do you like your hair/skin/beard/makeup/teeth or dentures to be looked after?
Where are your favourite clothes that are easy to wear and to wash?
Do you keep a hospital bag packed? Where is it?

If there was a choice between length of life or quality of living, what would you prioritise? Would anything change those priorities? For example, would you strive to live long enough for a particular person to visit, a grandchild to be born?

What are the local services to support older people? Do you want to engage with any of them now? What local hospice services are there? What reputations do they have? Would you like to visit? Many have open days: call them to find out.

Practical things: where's your water stop-cock? Mains electricity supply? Bank? GP? Are you under the care of any hospital departments? Who and where? Do you have a solicitor? Have you written a Will? (If not - do! It's horrid trying to sort things out after a death without one).

After you die: How do you feel about organ donation? Do you want to leave your body to science?
What sort of funeral would you like? Do you know that funeral directors will visit to plan ahead? So will clergy and funeral celebrants.

Would you like the support of a dedicated End of Life doula, who would work through all these issues with you either on your own or with your closest family members? They will make a contract with you and give impartial, wise advice. See @livingwelldying's website for more info.

Take a look at @giftedbygrief's website with workbooks and advice for planning ahead. Make a list of your insurance policies, credit cards, regular bank payments, etc.
Think about digital legacy, too: see @elainekasket.

How would you like to be remembered? Shall we have a family picnic or a religious service to celebrate your life? Plant a tree or make a charity donation?
This is quite an uplifting way to end the conversation.
Remember to write answers down, type it up & let them comment.

And finally...
Say thank you. This conversation is going to help future you to support future them, at a time when emotions are possibly running high. It's a very precious gift.

Take it slowly.
It might take several sessions.
It's OK.

Good luck.