Planning for your health-care needs

A letter from the Winnipeg Health Region

Winnipeg Health Region President & CEO
Wave, March / April 2011

Arlene Wilgosh

My father liked to have a plan for everything.

Weeks before heading off on a road trip, he would already know which hotels we would be staying in every night along the way - having a good plan was essential for my dad. That desire to have things ironed out even extended to his end-of-life wishes.

I remember the day he invited me over to the house to share his thoughts on this subject with my mother and me. Although he was in his mid-80s, he was still healthy, so the whole thing came as a bit of a surprise. But when something had to be done, it had to be done. So, for my dad, this was like planning another journey. He worked through all the details just as if it were another matter of business that needed to be dealt with.

He started by telling us that he had given the matter a great deal of thought. He even wrote down his wishes on a piece of paper. Dad didn't know it, but in doing so he was creating what we call a Health Care Directive - a legal document that stipulates the type of care the author wishes to receive should he or she become incapacitated.

Dad's Health Care Directive was not fancy - he didn't waste words. But it was comprehensive. He included details about the kind of medical care he wanted or didn't want to receive should he become very ill, as well as his wishes for when he died. My dad planned everything, right down to the last hymn for the funeral.

I'll never forget how difficult it was listening to my dad talk about his death. Even now, more than three years later, I get emotional thinking about it. But as painful as it was to have that conversation with my dad, his plan made it easier for my mom, my brother and me when he unexpectedly passed away a few months later. We knew what he wanted and how he wanted things to be.

While he was physically and mentally able, he had taken the time to think about what was most important to him and made a lot of decisions on his own, so we wouldn't have to.

In turn, I've also done some advance care planning and created my own Health Care Directive - partly for me, so that I will have a say in future medical treatment if for some reason I'm unable to speak for myself, and partly for my husband and my daughter, so they won't have to shoulder the burden.

It might be worth your while to consider doing the same. Whether you're heading into your twilight years, living with a chronic medical condition, or young and healthy, making plans now and sharing them with those closest to you and your health-care provider will ensure your wishes are known.

None of us can predict what tomorrow may bring. Hospital emergency rooms offer examples of that every day. A sudden stroke can leave a person unable to speak. A car crash might result in a child becoming dependent on a life-sustaining machine.

Sometimes the ability to make health-care decisions deteriorates slowly over a period of time. A young mother might be losing her battle against cancer, or an elderly man may be falling deeper into the grips of dementia.

There are many situations in which a person may find themselves unable to make decisions about their medical treatment. When that happens, someone else will have to make those decisions on their behalf.

You can avoid this problem. By doing some advance care planning and creating a Health Care Directive, you can help guide some of the choices that will be made about your care. Take some time to think about where you want to be cared for, what kind of care you'd like to receive, and how quality of life factors into those decisions. Through your Health Care Directive, you have the ability to appoint a spokesperson - like a family member or someone close to you - to be part of the decision-making process once you are no longer able to.

Health-care providers want to provide the best care. Part of doing that requires knowledge of your health-care goals, wishes, and what is most important to you. When this information is available, it allows everyone - you, your family, loved ones and health-care providers - to work together.

The benefits of having such a plan are clear. People who have a Health Care Directive will feel less anxious knowing that their wishes will be respected when they can no longer make decisions themselves. Family members may feel relieved that some difficult decisions do not fall upon them, or at least feel better able to make decisions because they are confident they are acting as the person would want. Conflict may be reduced among potential decision-makers, as many treatment decisions are already decided.

You can read more about the process of advance care planning and creating a Health Care Directive in this issue of Wave. Our story on page 30 features interviews with a number of Winnipeg Health Region experts who share their insights on this issue.

The story is part of a larger initiative to encourage everyone to think about advance care planning. As part of our effort, we plan to release a workbook, along with other resources, later this spring. These tools are designed to help guide you through the advance care planning process and will address important questions you need to consider when making decisions about your future health-care needs. For now, you can find some additional information on the subject on our website at

Thinking about our mortality is not an easy thing. But if we don't take the time to think about what type of treatment we want to receive should we not be able to speak for ourselves, it won't change the fact that decisions will have to be made. It's just that those decisions will have to be made by someone else.

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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