You start feeling aches and pains too often and quickly when you reach a certain age. And when you sustain an injury, it takes longer to heal. My mum once said that the insides of our bodies are like machinery, subject to wear and tear. As we age, our bodies require more maintenance, and it is sometimes a little too expensive when it gets a little too frequent. So at times like these, it makes sense to scrape the machinery from an economic point of view.
I see that resemblance when we discuss making ‘end-of-life’ decisions. Where life is concerned, it is more than just dollars and cents. Yes, it is expensive to ‘hang on with the help of a life support machine, but more than that, what would the quality of our life become?
Last year after much consideration and persuasion, our parents (especially our Papa) agreed to sign the Lasting Power of Attorney – (LPA) and the Advance Medical Directives – (AMD).
It is never an easy topic to have with your parents about the ‘end of life’ preparation and getting them to sign some legal document to commit to ending their life when the time comes. It almost seems unthinkable somehow.
From many conversations with my family and friends, I realised that not many people know about LPA and AMD, considering how crucial it is to know and have them in place.
So what are they, and why are they essential, at least for me.
Lasting Power of Attorney (LPA)
So what is LPA? It is a legal process to assign a person or persons (the Donee/s) to make decisions and act on the person’s (Donor) behalf when one loses mental capacity. The LPA covers two components; Personal Welfare and Property and Affairs. Personal Welfare includes making decisions on ‘end-of-life and resuscitation matters, whereas Property and Affairs touch on, as the name implies, properties and money matters. After all the parties have signed, the forms can be submitted to the Office of the Public Guardian (OPG) by post or hand.
Advance Medical Directives (AMD)
It is a legal document that one can sign to instruct the doctor to stop all life-sustaining treatments when death seems imminent.
You need to be 21 years of age before making all these important life decisions (both the LPA and the AMD), which form part of the advance care planning to prepare for that day when we can no longer make such decisions for ourselves anymore. After all the parties have signed, the forms can be submitted to the Registrar of Advance Medical Directive at the Ministry of Health.
It was a relatively fuss-free process for my family and me. We printed both the LPA and AMD forms, which can be easily obtained from the internet and filled these forms in the presence of an accredited medical practitioner. Because of convenience, we decided to get a certified doctor from Speedoc to come to our house to facilitate and witness the signing of the documents instead of bringing our parents to a clinic. Making your way to the clinic is cheaper because you could save on the chargeable house call fees. After all the forms had been signed, the doctor helped us submit them to the OPG and the Registrar, respectively.
As long as the professionals are accredited, you can also engage a lawyer or a psychiatrist to facilitate and witness the signing of the documents. After all the parties have signed and the forms submitted, you will receive letters from OPG/ Registrar for updates on your application status. Those letters were confusing (especially the ones from OPG) because all the Donors and Donees in my family were staying together, and the number of letters for each person involved seemed countless 🙂 What worked for me was to sort out the letters according to the addressee and in sequence according to the different stages of the application.
And there you have it, the LPA and the AMD. Again, something so important, yet not many people are aware of it.
I recalled having a serious phone conversation with the doctor about a year ago when my mum was hospitalised for a stroke. She told me about the possible health complications for mum (e.g. infections) that may result in a need for resuscitation. The doctor wanted to know the family’s decision on whether or not to proceed with the resuscitation when it is time to make that decision.
I told her what our mum had told us in many of our conversations with her, and that is, “as long as my heart can’t beat on its own, I can’t breathe on my own, let me go.” That is what my mum wants, and we shall respect that.
Imagine making that significant decision without knowing what your loved ones want. Wouldn’t you feel like you are carrying a tonne of bricks on your shoulders with that guilt of not knowing if you had made the right or wrong decision for them?