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The “Second Talk” is so important to create your Personal Directive

At some point when you had children reaching the puberty age, you had “the talk”. It was perhaps uncomfortable, but it was the right thing to do. They needed the essential information. You also need to have “the other talk” with your adult children for the same reasons- they need essential information, and it is still the right thing to do. Remember: Death is not an event, it is a journey, a process, and an experience.

Thinking about your own mortality/death is complex. What are your fears about dying? How can these be eased? Some people find it too difficult to talk about, while others are very vocal. Others may simply share only a few wishes or desires. Attending a Death Café is a great way to start thinking about your own mortality.

Expectant mothers often create birth plans with their team/birth doula. Have you considered making a death plan (Personal Directive) with a death doula? Preparing for your death can be a difficult journey but knowing what to expect may help you through the process.

When creating your death plan (Personal Directive) there are a few questions that need to be answered.

Who would you want to be around you? Consider family, friends, and religious leaders who you may wish to have at your bedside and possibly include anyone that you don’t want there as you would not find their presence to be comforting.

Who would speak for you if you were unable to do so? Planning in advance means you have made your beliefs and wishes known to a Substitute Decision Maker/Delegate. This person will be responsible for making decisions for you based on your expressed wishes if you cannot do this yourself.

What are your own needs, wishes or desires related to your own death? (e.g., DNRC, MAID, life-saving measures, comfort measures, dignity measures, medications, etc.). Talk to your family but do what feels right to you. Planning can help to reduce the stress on everyone during what may be the highly emotional times to come.

Where would you prefer to be during your final days- at home, in the hospital, or hospice? If your preference is home, discuss this with your family doctor and health care team to ensure this is feasible.

In Nova Scotia, the Personal Directives Act provides a framework for choosing a Substitute Decision Maker, known as a Delegate, and for completing a written document outlining your health and personal care wishes. This document is called a Personal Directive.

It is not a Do Not Resuscitate Confirmation (DNRC). This is an instruction to health care providers that lets them know not to take heroic measures to resuscitate the person who has signed the DNRC. This may be a very difficult subject to discuss with someone because most people do not want to die. The Substitute Decision Maker must still be consulted before any treatment is started unless there is an emergency where this is not possible.

There is also a common misunderstanding that a DNRC means “do not treat.” This is not the case - there are still many options for treatment to ensure that comfort, pain relief, and dignity are maintained. Some examples of types of comfort measures that you may want include certain medications, oxygen, massage, physiotherapy, acupuncture, music, and therapeutic touch. What would be comforting to you at the end of your life?

In conclusion, death doulas like me are a great resource and are skilled facilitators. I wish you a life well-lived and a death well-planned.

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