Thread by @drkathrynmannix

This is the time to have those tender conversations.
Not out of panic.
Out of love.
If you want to understand each other's wishes, here are a few questions to ponder together.
There are no right answers.
The only wrong answer is silence.

Here's @doctor_oxford's calming but important discussion of why we need to talk about dying:
theguardian.com/world/2020/mar…

We're all trying to minimise the risk of our most vulnerable citizens contracting the virus.
Let's all minimise the risk that any of us who get very sick end up with intrusive treatments that we didn't really want.
Some of us already know we don't want to go to hospital.

Some of us already know that, if they are so sick that death is likely, they don't want hospital, or tubes and drips, or ventilators. For some, the familiarity of home, even (or especially) if they are too sick to survive, is all.
Others want everything on offer.
Which are you?

Some of us would like hospital treatment to maximise our chance of surviving, but would want to limit how invasive the treatment is.
Will you agree to insertion of a drip?
Additional oxygen via a mask?
Isolation in hospital?
Admission to ICU?
Use of a ventilator?

Some of us would want everything, but if resources are tight we would prioritise people with longer life expectancy ahead of our own needs.
Some of us have things to live for & want to be considered for those resources.
Most of us have never asked ourselves that question.

Some of us would prefer to have our loved ones around us if we are dying; some of us would prefer not to put our loved ones at risk of the virus. Some of our loved ones may be too vulnerable to risk visiting. Does your family have a plan?

The Māori concept of Whānau - ties by blood or by love - is important, too. Do your family know who your close friends are & how to contact them? If you are very sick, who should be allowed to visit or encouraged to make phone/video calls?

Are there cultural, religious or spiritual traditions you want your family to respect if you are too sick to tell them? Do they know who to contact? What matters most to you?

If anyone gets seriously ill with the virus, make sure there's a good symptom management plan in place. Palliative care isn't just for the dying: it's for symptoms that are causing trouble. Many people will need treatment of muscle pains or breathlessness until they recover.

I'm going to say that again.
Palliative care isn't just for the dying: it's for symptoms that are causing trouble. Many people with #COVID19 will need treatment of e.g. muscle pains or breathlessness until they recover.
That's 'palliative care' AND 'recover.' It's not either/or.

Most of us & our beloveds will be OK.
But some of us will be sick; some will be sick enough to die, & yet recover; some will be sick enough to die, & will die.
Let's talk to each other now about how we want to be looked after, for the few of us who will be glad we did.

You might want a cup of tea with that.
This conversation is about listening. Ask each other the questions, then really listen: listen to understand this person you think you know so well. They may well surprise you.

#ItsTimeToTalkAboutDying