It always seems too early until it is too late.
Advance Care Planning (ACP) is for everyone, including healthy adults, and does not need to be done only in our senior years. More often than not, it usually takes a major illness to prompt such discussions with our loved ones. However, it is always better to plan for our future healthcare preferences when we are still well. In this way, it allows our needs and wishes to be met should we be unable to speak or communicate for ourselves and relieves our loved ones of having to make these difficult decisions.
Hilda (as she wants to be known) at 23 years old is one of the many who had their ACP done with an ACP Facilitator at Khoo Teck Puat Hospital. The hospital hopes more young adults will consider having their ACP done.
How did you first know about ACP?
I found out about it at a volunteer training on ACP in August 2018.
Was there any past experience, e.g. from a loved one, that contributed to your decision of doing an ACP?
No. However, months after I got my ACP done, I had my first experience of death in the family. It does not feel real that someone I knew for my whole life is now gone. When I was a child, I was close to my grandfather who taught me watercolour painting. We grew distant as I got older because it became harder for us to communicate due to my limited vocabulary and his hearing loss. Upon knowing about his death, I did not know how to react. In the days leading to my grandfather’s death, he was in a lot of pain and could not communicate his wishes to my mother and her sister. Both of them could not come to an agreement on whether to prolong his life or to let him go. I am bringing this story up to illustrate that these difficult decisions may have been easier if they had talked about it before it became too late.
What made you decide to finally do your ACP?
I had wanted to try it myself and use the experience to persuade my parents to get their ACP done as well — it’s still a work in progress. As I am an only child, I worry about not knowing what to do when my parents pass away. We do not talk about end-of-life matters as they are resistant to it.
Did you discuss with your family and/or friend(s) while considering to get your ACP done?
No. I simply did a search online on where I could get my ACP done without charge, then proceeded to make an appointment for myself. On hindsight, it may be more effective to talk to my parents and have one of them join the session. After all, an ACP is a piece of document. What matters more is the conversation, where we have a nominated healthcare spokesperson listen to you and respect your wishes.
Did you encourage your family and/or friend(s) to do their ACP as well?
Yes, I shared about my experience during my volunteering work and if I sense that my friends are interested, I would encourage them to get their ACP done. However, I do not rush people into it. I rather trust that they will do it when they are ready.
What do you think is one major advantage of having an ACP done?
ACP covers a broad range of questions beyond healthcare preferences. For example: “What makes each day meaningful?”, “What are the important aspects about your well-being?”, “Who or what helps you face serious challenges in life?”. Thinking about the answers to these questions gives one the opportunity to reflect on what is truly important to them. This is then a chance for them to make choices that are congruent with their values. Life and death are two sides of the same coin; in planning for their death, they also plan how they want to live.
It always seems too early, until it’s too late. How would you encourage young adults like yourself to start planning for their future healthcare preferences, while they are still healthy?
I understand that thinking about your own mortality can be scary, and that is normal. In your youth, you want to savour your own vitality, to feel alive and delay adult responsibilities for as long as you can. Having an ACP done does not mean that you have everything figured out. It also does not mean that you must be fearless of your own death. You simply accept that death is inevitable; it will come to everyone eventually. Hence, what we can do is really to prepare as much as we can. Starting your ACP conversation early will bring you comfort in the future.