PREFACE

This document has been written by a 77 year old who is neither a doctor nor a lawyer. The document records the author’s learning experiences as she aged. She hopes they will be of practical use to other people as they get older. The document is not unbiased and if for you “Life is Sacred” it may not prop up your beliefs.

Steps You Can Take to Ease your Path to the End of Life

You cannot prevent death or taxes but you can do a lot to make both easier for you and your loved ones. Taxes are for accountants; these notes are about end of life and making it easier for you and those close to you to end your life in the manner you would wish. Most of us say that when our time comes we want to die quickly and without pain. If you complete the six steps below you can go some way towards achieving this.

It is important to understand that as you age there is an increasing possibility that you will lose mental capacity. Not all of us do, but if you are one who does, you will no longer be able to take any legally binding decisions about your own future: and no-one else can do it for you.

With the exception of your Lifebook, this means that you will not be able to complete the undernoted actions and usually no-one else can do it for you.

1. 1. Your Will
2. 2. Power of Attorney
3. 3. Age UK Lifebook
4. 4. DNR Do Not Resuscitate
5. 5. Additional Directive
6. 6. Your personal wishes for your end of life
7. 7. Dignitas

It is therefore very important to do these things whilst you still have capacity and can sign documents to make them legally binding. You need to understand that, in most cases your attorney cannot sign these documents for you. Start today. You may complete as many or as few of these actions as you wish. Each can stand independently of all the others, but the more you complete the more protection you will give yourself and those that look after you.

1. Your Will

Approximately 30 million adults in the UK have no will. If you don't leave a will, it will be the law decides how your estate (money, possessions, property etc) is passed on, and it may not be in line with your wishes. Laws in Scotland are different from those in England, so you should consult a solicitor and make a will under Scottish law. You must be of sound mind when you do it and you will have to sign every page.

So if you do not have a will in place, you could get a template on line but it is much wiser to make an appointment to see your solicitor.

Before you go think about:

your surviving children and spouse are entitled to claim a share of your moveable estate

who you want as executors and / perhaps trustees

make a list of the money or specific items of your property that you wish to leave to specific people.

who receives the residue of your estate

if you choose to partially or fully disinherit a child or spouse in favour of a chosen charity, you would be wise to leave a letter with the will explaining your reasons behind the decision

if you have heritable assets overseas, seek the advice of someone specialising in the laws of that country

2. Power of Attorney

A power of attorney is a legal document which gives someone else permission to make decisions about your money and property as well as your health and personal welfare. The person in whom this power is invested is commonly known as “an attorney”. Don’t confuse the term with an American solicitor.

The Power of Attorney usually sets out what you would want to happen in the future if you lose capacity and can no longer look after your own affairs. It is normally considered sensible to have two powers of attorney, one to look after your welfare and another to take care of your finances. In choosing the person in whom you are to invest these powers it would be wise to pick:

someone who is a generation younger than you (you don’t want them to die before you)

and if possible someone who is not short of money themselves (you don’t want them squirreling yours away)

You should get all the paperwork in place as soon as possible whilst understanding that it will not be “triggered” until you lose capacity. In due course it will be registered with the Office of the Public Guardian (Scotland). Note if you have already lost capacity it is too late. All sorts of problems lie ahead for you and your loved ones. If you lose capacity and have NOT got your own attorney/s, the Office of the Public Guardian will appoint one for you. It could be someone you have never met and who knows nothing about you. Do-it-yourself kits are available on line but clearly it is wiser to see your solicitor

3. Age UK Lifebook

The Age UK Lifebook has two main purposes:

It will certainly help you to be organised and to remember where you keep important documents and information.

In addition the time will come when someone else, maybe your attorney, or a family member or a friend, needs to find important information about you in an emergency.

Your completed Lifebook should provide all this. The step by step instructions are straight forward and easy to understand. Just fill in the various sections with your details, contacts and locations of important documents. You don’t have to do it all at once - just complete it at your own pace. It really is invaluable.

Your can either

fill in the standard booklet in hand writing

Use the format of the booklet but type and print the required information. This has the advantage that it can more be easily read and copied for the benefit of close family or friends

The LifeBook is available as a free booklet by post or e mail from Age UK on 0800 169 8787 or 0345 685 1061. Age UK Tavis House 1-6 Tavistock Square, London WC1H 9NA.

4. Do Not Attempt Cardio-Pulmonary Resuscitation

Is often abbreviated to DNR or DNACPR, or referred to as Do Not Resuscitate.

Cardio-Pulmonary Resuscitation (CPR) is an emergency treatment that attempts to restart your heart and breathing when they have stopped.

Some facts about CPR:**

repeatedly pushing down firmly on your chest

using a mask or a tube to help you breathe, and

using electric shocks to try to restart your heart

very few people make a full recovery

people who are resuscitated will still be very unwell and need more treatment, usually in a coronary care or intensive care unit

most patients never get back the physical or mental health they had before they were resuscitated. Some have brain damage or go into a coma

patients with many medical problems are much less likely to make a full recovery

CPR is often very painful; it can break ribs and very occasionally punctures a lung

** copied from NHS Scotland website

Whilst you are in sound mind you have the right to choose whether or not you wish to be resuscitated should the situation arise. If you lose capacity it is too late to protect yourself from Cardio-Pulmonary Resuscitation. In most cases your Attorney does NOT have the authority to take this decision for you.

Take your decision today by making an appointment to see your GP who will put the necessary steps in place. Keep your document in a very obvious place. Emergency medical staff arriving at your home need to know whether or not to resuscitate you.

5. Advance Directives aka Living Will

An Advance Directive (sometimes called a Living Will) is a written statement of your wishes to refuse a particular treatment. It is a way of making sure that everyone knows what treatment you do NOT want to have if you are unable to make your own decisions in the future.

If you develop an incurable and irreversible condition, are persistently unconscious or permanently mentally impaired an Advance Directive may be used to ensure you are:

Not given life support or live prolonging treatment

Not fed by tube

Not to receive Cardio-Pulmonary Resuscitation

An Advance Directive:

must be made when you have full legal capacity

can be revoked at any time

cannot include a request to have treatment

cannot include a request to have your life ended.

This is a significant legal and medical document and whilst pro formas are available on line, first see you GP and / or your solicitor. In most cases your Attorney does NOT have the authority to take this decision for you.

6. Your Personal Wishes for Your End of Life

When you have completed the items on this check list, re read what you have written; stop and think. Not all your wishes will be there. You are an individual and it is almost impossible that these official processes can cover all of every individual’s wishes.

Write a list of all the things that have been missed out and make sure that your GP, solicitor, attorneys etc all get a copy.

7. Dignitas “Dignitas is your last best insurance”.

“DIGNITAS – To live with dignity - to die with dignity” is an association in accordance with Swiss law and was founded in 1998 near Zurich. The organisation, which pursues no commercial interests whatsoever, has in accordance with its constitution the objective of ensuring a life and a death with dignity for its members and of allowing other people to benefit from these values.

The activities of DIGNITAS comprise, amongst others:

Counselling in regard to all end-of-life issues

Cooperation with physicians, clinics and other associations

Carrying out Patient’s Instructions and patient’s rights with regard to doctors and clinics

Suicide- and suicide-attempt prevention

Support in conflicts with the authorities, with the management of nursing homes and with doctors not chosen by the patient

Further legal developments in regard to questions about “the last issues”

Accompaniment of dying patients and assistance with a self-determined end of life.

Dignitas is a membership organisation. Like many clubs there is an entrance fee and an annual fee. If you want to avail yourself of their services you must first become a member and you must have full capacity when you do so. Your regular payment of an annual fee will go a long way to convince a court (should it come to a court) that your decision to go to Dignitas is a long held belief and not a sudden, ill thought out response to a sudden illness.

The laws in Switzerland are different to Scotland. In Switzerland if you suffer from terminal, unpleasant, unbearable medical conditions and / or disabilities Dignitas can legally assist you in self administered end of life.

In Scotland you just have to grin and bear it.

DIGNITAS
P.O. Box 17
8127 Forch, Zurich, Switzerland
Telephone international: +41 43 366 10 70
E-mail: dignitas@dignitas.ch

In most cases your Attorney does NOT have the authority to take this decision / action for you.

FOOTNOTE 1

All the above actions need to be taken whilst you have mental capacity. Please complete these actions before it is too late. None of us know what lies ahead… you might have a stroke tonight … and then it will probably be too late to protect yourself from the very worst aspects of old age and death.

FOOTNOTE 2

The author’s solicitor has recently advised that surprisingly frequently well meaning friends and family members challenge decisions about DNR, Additional Directives and Dignitas. The most commonly used challenge in these cases is that the documents were signed years ago and that since then the signatory has changed their mind but did not shred the documents.

The single most useful defence against this is to make sure that each document is signed and dated again by you every year. Surprisingly the NHS considers that signing documents only every three years is adequate. Whichever, repeated and regular signatures are proof that you did not change your mind. Hence your wishes are more likely to be carried out.

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© Margot Kennedy no 11 AB31 4BB UK