By Kate Proctor

    As the old saying goes, nothing is certain, except death and taxes. As a new year rolls around again, many people take stock of their health – physical, mental, and financial – in an attempt to stave off both death and taxes. But maybe taking some time to plan for death – or even talk about it – could be one of the best things you can do to plan for the future. 
    Talking about death is something most people avoid at all costs. Unfortunately, this reluctance can lead to generations-long ruptures in families, unnecessary suffering, and other negative consequences. Today, people talk about having a “good death”, something that happens when people are willing to really think about what matters and tell their loved ones what they want ahead of time. 
    Starting this discussion can be difficult, but there are tools available that can help. Hospice Palliative Care Ontario (www.hpco.ca) initiated Advance Care Planning, which provides tools and information about starting this process yourself. “We aim to raise awareness about the importance of advance care planning and provide people with the tools and information to begin their own advance care planning. Hospice Palliative Care Ontario works closely with people from healthcare, law, ethics and research who provide leadership and guidance for this initiative,” https://advancecare planningontario.ca.
    The first step in Advance Care Planning involves thinking about who you would choose as your “Substitute Decision Maker” (SDM). This person will make decisions for you if you are unable to do so yourself. This could be the result of a long-term illness, such as dementia, but can also be the result of something sudden, such as an accident or any other occurrence that may cause you to lose consciousness. 
In Ontario, everyone has an automatic SDM – this is the person who is most closely related to you at the time that you need an SDM. This could be a parent, child, sibling, or spouse. Thinking about who you actually want to play this role in your life is an important first step. You could choose to name someone who is not related to you to play this role. You could also choose to name one of your close relatives in the instance where you have multiple relatives who could equally perform this task. If you have multiple siblings or children, all would be your automatic SDM if you have not taken care to name one or two people. 
     In order to name someone other than the automatic SDM, you must go through the legal process of naming an Attorney for Personal Care.  The role is important, and you should think about who you have entrusted to make your life and death decisions on your behalf. As life rolls on, the person you have named could change. Should you perhaps have someone else named to do this for you? How are the people you have named changing in their own lives? Are they still willing and able to do this for you? Even people who should know better have left their ex-spouse on as Attorney for Personal Care because they just didn’t bother to change it and wound up unconscious with vital decisions required of that person. It happens. 
    Naming a person for Attorney for both Personal Care and Finance is often done in conjunction with preparing a will, and it is very important that the people you name have copies of these notarized documents. I have learned the hard way that being placed in this role means nothing if you don’t have the paperwork to prove it. When urgent decisions are required, it is often too late to obtain this paperwork. If you are unconscious after an accident, you are not able to give permission for your lawyer to release these documents, and your carefully named Attorney for Personal Care will be powerless to help you. 
    Aside from the legalities, there are other aspects to consider. When most people hear the word “palliative”, they automatically think that death is imminent. However, according to the Cambridge Dictionary, to “palliate” actually means “to reduce the bad effects of something”. Palliative care is more about giving people the best possible life with the life they have left when dealing with an incurable disease. Palliative care can start anytime after a person has a diagnosis of a condition that will limit the length of their life. 
    Dame Cicely Saunders, noted for her role in the modern palliative care and hospice concept, was the driving force behind the first hospice constructed in the world in 1967, St. Christopher’s Hospice in England. “You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die,” Cicely Saunders. 
    I recently took a course through Hospice Palliative Care Ontario, in order to volunteer with our local Huron Hospice. The course was an eye-opening experience for me. The Huron Hospice website provides a lot of good information about the services they provide.  “Hospice is a concept of care with a focus on caring, not curing, living not dying and helping to provide quality of life until the end. Hospice is all about HOPE”, www.huronhospice.ca . The hospice in Huron County has been providing care for people for almost 30 years. This can happen in the home, in the hospital, in long term care residences, and in Bender House, the residential hospice located near Clinton.
    Unfortunately, often the first time we encounter death, we learn too late what we don’t know. Learning about the end of life can help us and our loved ones prepare for something that is unwelcome, but inevitable.  It can even lead us to think about what is really important and to live our best life, no matter what stage of life we are currently in. ◊