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There is always a final destination for one’s life journey. You still dare not touch upon this topic? Have the carers tried to understand the will of the parents and let them complete their life journey happily without any concern?

Many individuals deliberately avoid talking about this topic as they think that parents are reluctant to talk about these “ominous” issues, or they are worried that this topic would bring along uneasy and negative emotions for parents. Parents do not have the opportunity to express their thoughts and intentions in advance, while their children do not take the time to understand the will and choices of their parents. When old parents become unable to express themselves, one may panic and make regrettable decisions for parents according to the children’s will.

Many people insist on requesting doctors to adopt life-sustaining treatments for their old parents at the terminal stage of illnesses. The original intention is to hope that one’s parents may live longer and stay with the family longer. However, this decision may bring a lot of unnecessary suffering to parents approaching the end of their lives. Or when parents are at the terminal stage of illnesses and become medically untreatable, contradictions and pressure arise as children have to make decisions on behalf of their parents regarding whether to continue or cease such life-sustaining treatments. Some may even come to know of the parents’ belief in other religions from relatives and friends after a Chinese chanting funeral is arranged. While the parents will never know, unchangeable guilt will stay in one’s heart forever.

In fact, many elderly people understand that there is an end to one’s life journey. They are not afraid to talk about this topic as they know that it is completion rather than the ending of life. Being able to communicate positively and openly with one’s parents about life and death, prepare advance planning as early as possible, and understand parents’ thoughts and will in advance, so that parents may know that their wishes will be fulfilled and they can complete their life journey with peace of mind and a sense of dignity, are ways to truly express respect and love for one’s parents.

Will

When talking about advance planning, one usually focuses on property settlement and funeral arrangements. Wealthy parents will make a will to properly settle and assign their properties. In this way, parents can handle their assets according to their own will and avoid unnecessary disputes among family members. You can find out information about Will under the thematic page “Joy” of this website. You may also refer to the following website:
After-death arrangements

In addition, some elderly people plan their burial arrangements in advance. Apart from acquiring the columbarium, some prearrange their own funeral ceremonies, coffins, photos, decorations for the mourning house and the burial method, so that family members will be able to arrange the funeral according to the will of the deceased without any trouble. For information on after-death arrangements, you may refer to the following websites:

In fact, the medically-ill elderly may make their own choice of medical treatments in advance while they are still able to make decisions. This could facilitate discussions with medical staff and reduce the difficulties, pressure and contradictions faced by caregivers as they are able to understand parents’ wishes as early as possible.

Life-sustaining treatments may lengthen the life of parents when their illnesses have come to a terminal stage, but these treatments, such as access to ventilators, cardiopulmonary resuscitation, use of cardiac drugs, and access to feeding tubes, can only extend their life for a certain time but are unable to reverse their medical condition. These treatments may also cause unnecessary pain and harm to parents. When facing such situation, the medical staff will discuss with the patients and their family members whether to continue to provide these meaningless life-sustaining treatments. As carers, it is important to gain an early understanding of parents’ wishes and be able to respect their decisions.

“Advance care planning”

“Advance care planning” refers to the future medical and care plan when patients are in a critical condition generated after communications among patients suffering from serious illnesses, their family members and medical staff, taking into account the patient’s medical prognosis, pros and cons of treatments, the patient’s wishes and other factors. The patient may express his/her medical care plan and his/her wishes. “Advance directives” can also be made to refuse any life-sustaining treatment.

Suitable timing to discuss “Advance care planning”:
  • The patient’s body functions and mobility deteriorate significantly, or he/she needs to be accommodated in a long-term residential care hostel
  • The disease has caused physical and mental illnesses to the patient
  • The illnesses have entered a terminal stage with frequent hospital visits and an increasing number of acute exacerbations
  • The medical staff believe that specific treatments are ineffective and the direction of treatment shifts from curing to palliative care

Details of “Advance care planning” may be obtained from the Hospital Authority’s website (Chinese version only) .

“Advance directives”

Adult patients who are mentally capable of making decisions on their own can make “advance directives” to indicate refusal of life-sustaining treatments under specific circumstances when the patients are unable to make decisions due to the terminal stage of a medical condition, a long-term coma or a vegetative state. “Advance directives” may provide autonomy for patients with terminal diseases and help them determine their own medical treatments. This could eliminate the hardship of family members in regard to decision-making when patients are in a critical condition, and help medical staff make medical treatment decisions. Under common law, valid and applicable “advance directives” enjoy statutory effect.

Details of “advance directives” may be obtained from the Hospital Authority’s website (Chinese version only).

At present, the Hospital Authority offers “advance care planning” and “advance directives” to patients suffering from critical and irreversible diseases. Patients without serious and irreversible diseases and the healthy elderly may not be suitable for drawing up these instructions. Nevertheless, it is easier to discuss the matter with medical staff as early as possible when an elderly relative is suffering from a critical illness in order to understand “advance care planning” and “advance directives”. By discussing medical arrangements with parents, carers can obtain an early understanding of their parents’ wishes and provide more suitable and appropriate care for them.

Parents’ physical and mental conditions will change over time during their life journey. While carers should adopt various ways of care and interactions based on different circumstances, carers’ love for their parents and the priceless family relationship between each other will never change.

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