Advanced Care Planning
By Dr. Aparna Hegde,
Cosmetic & Integrative General Practitioner, Educator A5M & ACAAM, Advisory Panel Member A5M
MBBS, FRACGP, MPH & Tropical Medicine, Dip Aviation Med, ACAAM
Advanced care planning involves discussing your wishes and needs with your family, friends and health care providers of what you want with regards to your medical care should the time comes when you are too impaired to make decisions for yourself or nominate someone who could make these decisions for you.
As an anti-ageing and functional medicine doctor, I believe in holistic health care for both life and death. Part of living a happy and healthy quality life should be planning for the end of life. Not surprisingly, the focus in my field is on the advances in supplements and diets designed to promote longevity and this topic gets completely forgotten. This type of plan should be made when you are healthy and able to competently make decisions for yourself. I have practised what I am preaching here. I am a healthy person without any ongoing medical issues, but I have talked about what I want if the time came with my family including my decision to become an organ donor if that became an option.
Imagine the scenario of 96 year old man brought into hospital following a massive stroke with little chance of recovery. He has led a full life having a fulfilling career, large loving extended family with whom he has done Advance Care planning and has an Advanced Care Directive in place stating that he did not want to be resuscitated. In hospital, his Directive would be taken into account by his doctors. He would not be resuscitated aggressively, intubated and put on a life support machine in a vegetative state ensuring a peaceful transition to the end of his life surrounded by his loved ones in accordance with his wishes. His family are comforted by the thought that they are doing what he wants and the process of his death becomes easier to deal with and it makes them closer.
All too often, these important discussions never take place and there is nothing in writing. The individual cannot voice their preferences and doctors make decisions based on clinical protocols. Resuscitation in the 96 year old man would involve intubation with a breathing tube, a number of needles for intravenous drugs, CPR with inevitable broken ribs followed by the unconscious individual on life support until the decision is made to stop. This results in families that are distressed, anxious and traumatised and is a complete waste of scarce health care resources.
Advanced Care Planning is particularly important for the elderly and individuals with serious or chronic illness but I would urge everyone to open these discussions including the preference to become an organ donor with their loved ones and make an appointment with your Azure Medical GP to start the discussion process. We can help you with ideas on how to start talking about it with your family and set up an Advanced Care Directive. Start 2019 right and book in your appointment. The website Advance Care Planning Australia is a great resource for individuals and families and has lots of useful information on how to start the discussion as well as templates for a written Advances Care Directive- https://www.advancecareplanning.org.au/
Published by A5M with permission from the author
Dr Aparna Hegde can be found at Azure Medical in Perth, WA.
She is a UWA (1994) graduate who has specialised in General Practice and Aerospace Medicine. Aparna completed her certification in Anti-Ageing Medicine with A5M in 2017 (ACAAM). She has a special interest in Women's Health, she is experienced in the use of bio-identical hormones and supplements to restore normal physiology. Aparna was in the RAAF full time for 11 years and is still in the specialist reserves.
A5M Medical Education - Providing training, certification and continuing education in Preventative, Integrative & Anti-Ageing Medicine
www.a5m.net | +61 3 9853 4123 | ABN 79 763 657 407