Making decisions about health care can seem overwhelming at times. The issues are often complex and involve subjects that we’re not used to thinking about in our day-to-day lives. The intensity of decision-making is magnified when life-threatening illness is involved. The stakes feel very high for every choice that arises. If you are dealing with life-threatening illness, you’ll face many decisions, and not just about what type of care is desired. All of these decisions can feel complicated and difficult. Almost all decisions related to health care in palliative situations can be approached by using the following framework:

  • be informed about the issues being considered
  • determine the goals for whatever is being considered
  • determine whether the hoped-for goals are possible to achieve and plan an approach accordingly

Advance Care Planning/Health Care Directive

Advanced Care Planning is the process of thinking about and writing down your wishes or instructions for present or future health care treatment in the event you become incapable of deciding for yourself. Talk with loved ones and health professionals about the types of care that are or are not preferred, including conversations to continue or to abandon life-support measures. Don’t assume your family and health providers know what you want. As part of advance care planning, you are encouraged to complete a Health Care Directive expressing your wishes about the amount and type of health care and treatment you want to receive should you become unable to speak or otherwise communicate this yourself. Completed by yourself, with someone else or with your legal counsel, this legal document allows you to give another person the power to make medical decisions for you should you ever be unable to make them yourself.

As part of advanced care planning and health care directives, the role of the ‘substitute decision-maker’ can be a delicate task for the chosen person. When representing someone else, we do not stop being ourselves – son, daughter, sister, brother, spouse, life-long friend. In the time following the person’s death, the pain and grief that survivors sometimes feel may be a difficult journey. Such feelings are understandable. They may feed the sense of uncertainty experienced by anyone who acts as a substitute decision maker. This is normal but know that you are not alone and you are encouraged to seek support as needed.

Treatment Options

Discussion about treatment options often includes concerns about withholding, or withdrawing treatment. It is normal to be concerned about stopping or changing medications or treatments. It is important to discuss the benefits and burdens of different medications and treatment options openly with your doctor and other health care providers.

Talk to your doctor about specific treatment options, CPR and life support and chances for recovery. A key part of this process is including your family in these conversations to discuss options together and clearly state end of life wishes and preferences.

Compassionate care leave/benefits gives employees the opportunity to take up to 28 weeks of unpaid leave to care for or support a critically ill family member who has a significant risk of death within the next 26 weeks. Visit the Province of Manitoba Employment Standards website to determine your eligibility.

Symptoms

As an illness progresses, you may not know what to expect and may have questions about:

Caregiving

More than 8 million family and friend caregivers in Canada are providing care in the home.
Being the caregiver in a palliative journey can be both a rewarding and difficult experience. When caregiving goes on for a long period of time or when there are specific challenges in providing care, you may feel taxed and stressed. A palliative care nurse can also support family and caregivers in sharing useful approaches and techniques to give care and make practical suggestions to address any concerns. Also, remember to take care of yourself to ensure you can continue taking care of your loved one. Access the caregiver resources below to assist you in this journey:

Medical Assistance in Dying (MAID)

We understand that while looking into palliative care services, some may be looking for information about Medical Assistance in Dying (MAID). MAID is not connected with the Southern Health-Santé Sud Palliative Care Program, but is a distinct service. Get more information about MAID:

Shared Health Manitoba

Southern Health-Santé Sud MAID Policy