16 Apr 2014

NZers urged to plan for end of lives

9:30 am on 16 April 2014

A national campaign is being launched to encourage New Zealanders to decide how they want to be cared for at the end of their lives.

Nurses, GPs and specialists are all advising patients to start having "conversations that count" as part of Wednesday's awareness event into Advance Care Plans (ACP).

Nelson man Mervyn Barker has suffered from heart problems for more than 30 years and has incurable heart disease.

He said the ACP gave him the peace of mind he was desperately seeking.

"I thought 'what a jolly good idea'. I wish more people could know about it. It would save a lot of stress on families, it would save a lot of hassle between family members," he said.

"It's a bit like a wedding I think, a funeral, because there's always somebody who's going to argue over something."

But he admitted it had been hard to discuss the issue with friends and family.

"I did to one friend but he said 'I don't want to know'. He doesn't like talking about death or things like that, and I said 'well I never did, either'.

"But I do know a lot of men who won't talk about it, whereas I think ladies will."

His wife, Pam, is filling out her own ACP and agrees it makes it easier knowing her family is aware of her wishes.

"If I go first, or anything happens, he knows what I would like and I know what he would like," she said.

"And our daughter will know what we would like. There'll be no her saying 'I don't want you to do this Mum' and I'm saying 'but your father wanted that'.

"But a lot of children do not want to talk about their parents passing on. You start to say something to them and they say 'I don't want to hear about it'."

Everyone should have one

Mr Barker's doctor, cardiologist Tammy Pegg, said everyone should be filling out an ACP.

Her own related more to what she would want in the event of a significant head injury, or if she was in persistent vegetative state.

"If you look at somebody unfortunate like Michael Schumacher, who's had a significant, unheralded, head injury, his family are now left making significant decisions about his long-term care without any understanding of maybe what he wanted," Dr Pegg said.

Renal physician and medical ethicist Alastair Macdonald agreed, saying a plan could offer peace of mind to both the patient and their family.

It provided them with the thoughts of a person about their future, which empowered them and gave the family peace of mind.

"It goes a long way to ensuring that unnecessary interventions are not carried out," Dr Macdonald said.

Auckland City Hospital neurologist and ACP spokesperson Barry Snow said planning ahead could actually improve life expectancy.

"Yes it's a taboo subject but there's a reality here - we're all going to die. And especially people with chronic illness, we do know that if they've had this conversation they tend to actually lead better lives," Dr Snow said.

People were happier, less depressed and there was evidence that with a good ACP, people actually lived longer, he said.