Northland DHB Renal
Public Service, Nephrology
Advanced Care Planning
Advanced care planning is all about keeping you in control of your own healthcare even if you become unable to speak for yourself. We hope that everyone remains as well and healthy as possible but sometimes things change and it helps you, your family and those looking after you, if we know what you would like to happen. It is a huge burden for family members if they suddenly have to make important decisions on your behalf at a time when everyone is very stressed and worried.
There are different ways you can help with this:
1) You may choose to discuss this with your kidney doctor, primary nurse or your GP. You may feel happy that this is enough for you and not wish to keep a formal record. Or you may ask the doctor to record your decisions on your behalf in your medical record.
2) You can discuss this with your family so that they are all aware of what you want to do. You can also consider appointing one member of your family to have enduring power of attorney (EPOA) for you for health and wellbeing. This would be particularly important if your family have different opinions and there is likely to be disagreement. Please do not be afraid to do this as EPOA only becomes active if you cannot speak for yourself. If you are still able to do so, your opinion will always be the first priority.
3) You may prefer to complete a form to document your wishes. There are examples of ones and information leaflets about it on this website http://www.advancecareplanning.org.nz/. This form can be held by you, your GP or in your hospital record. You can tear it up any time that you wish if you change your mind.
Examples of some ways you might like to approach this:
1) “I have a great quality of life and want to have all possible life sustaining measures applied to me.”
2) “At present things are good for me and if I should collapse I would like brief attempts to re-start my heart. However, if that does not improve matters, then I don’t want to be taken to the Intensive Care Unit or to be put on a ”life support machine.”
3) “If I have a new illness that is going to leave me very dependent for my normal activities of daily living (such as eating, dressing, bathing etc) then I don’t want any new life prolonging treatment.” You may even want to state that in that situation you would like to stop dialysis.
4) “I feel that I have had a full life and feel that my health problems are now becoming a burden for me. If I should have a collapse then I would like nature to take its course and do not want people to interfere medically. Just keep me comfortable.”
5) “I want all life sustaining treatment while my partner is alive, but if they are not, then I would prefer nature to take its course.”
These are just examples and you may have different ideas that are unique to you.