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Palliative Care: Our Scalabrini Approach

Palliative care is a type of family-focused assisted living with medical help for individuals with serious life limiting illnesses, including end-of-life care. The goal of palliative care is to ensure dignity is upheld and to provide individualist care to meet the specific needs of a person in order to best help them live comfortably.

Scalabrini’s approach to palliative care is highly tailored to each individual, with our Advance Care Planning ensuring that families, medical professionals and our team are all on the same page regarding a person’s wants and needs for their future care. We also make sure that the preferences expressed by the individual’s loved ones are also taken into consideration during this time.

We ensure our specialised team is providing the correct support needed and improving an individual’s quality of life. Palliative care at Scalabrini means that we are managing pain and symptoms with high quality levels of care, where registered nurses are on staff 24/7 to meet any needs presented.

However, we treat more than just physical symptoms. Our focus on holistic wellbeing means that while also looking after physical aspects, an increased quality of life is also managed in emotional, spiritual and social aspects.

This high level of care also extends to our treatment of an individual’s family and loved ones. Scalabrini always operate in a way that upholds a strong expression of sensitivity, compassion and understanding.

Our brilliant religious Sisters are available at each village location 24/7. They provide prayer, companionship, grief support and spiritual & emotional comfort to all our residents and their loved ones regardless of religion or faith.

We understand and respect that this season contains a lot of distress, conflict and hard decisions. Our team is always here to guide you through the process and provide all the information and support needed to make a fully informed choice. You can contact our team for more details by emailing us at enquires@scalabrini.com.au or calling us at 1800 722 522.

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How to manage family arguments about end-of-life care

Preparing for the end of a loved one’s life is never easy. There’s often a flood of emotions that accompany it, from grief and loss to the stress and frustration of dealing with all the logistics. 

While the ideal scenario is that everyone in your family would band together in this challenging time, this unfortunately isn’t always the reality. It’s not uncommon for family conflict to break out in this emotionally charged scenario.

From deciding on the best medical care to preparing the will and arranging the funeral, there’s a lot of moving parts involved in end-of-life planning. It’s likely that there will be a few different opinions on the best way to give your loved one a dignified passing.

With a few simple changes to your approach, you can avoid clashes and get everyone on the same page. 

Whether you’re preparing for the imminent passing of a loved one or it’s already happened, here’s how to handle family arguments about end-of-life care.

Identify key decision makers

There’s a good chance that everyone and their dog will have an opinion on the best end-of-life arrangements for your loved one. However, that doesn’t mean that everyone’s viewpoint is relevant. If you take every opinion on board, it will likely end up as a ‘too many chefs in the kitchen’ situation, where nothing gets resolved.

This is why it’s important to identify the key stakeholders who should be involved in making these arrangements. For example, immediate family, like children or spouses are traditionally involved in the proceedings, while grandchildren, cousins, and partners of children don’t necessarily need to be. 

If your loved one is still alive and able-minded, you may also choose to consult them about who they would like to be involved in their end-of-life planning.

At this stage, you may also choose to appoint roles with the consent of your loved ones. For example, some of the legal appointments around end-of-life planning include:

Medical treatment decision-maker – can manage your medical needs

Enduring power of attorney – can make financial decisions

Enduring guardianship – can make personal and lifestyle decisions

Doing this can ensure everyone has a clear understanding of exactly what their role is and what they have authority on, so nobody steps on anyone else’s toes.

Listen to everyone’s viewpoints

Once you’ve decided whose opinions will be taken into consideration, it’s time to listen to them. It’s really important that everyone has the opportunity to have their preferences heard and respected. Now, if you have a family dynamic where everyone talks over the top of each other, this can be challenging! 

You may want to consider implementing a talking stick (a Native American tradition) where only the person holding the stick can talk, and everyone else must listen until it’s their turn to speak. This helps slow down the conversation and gives the quieter members of the family the chance to be heard, too. 

Face tough conversations head-on

It can be tempting to avoid communicating about end-of-life planning in-person — particularly if you have a complex family dynamic or are separated by distance. 

However, communicating about these important issues via email or text can be rife with issues. You lose many of the visual and verbal cues that you get with face-to-face communication, such as body language, tone, or facial expressions. This can lead to family members misinterpreting the intention of others, which can cause conflict.

Where possible, it’s best to have these conversations in-person or at least via video call. 

Stick to the facts

Humans are emotional creatures at heart, and this is especially true of high-tension situations like the passing of a loved one. Everyone deals with grief in different ways, whether it’s feeling angry or emotionally shutting down. However, in order to reach the best outcome for everyone involved, it’s important to put emotions aside and look at the facts. The same applies to not bringing past family conflicts and dramas into the equation.

What were your loved one’s wishes for the end of their life? What makes the most sense, financially and logistically? How can you meet in the middle to reach an outcome that benefits everyone? These are all important questions to ask in order to make a rational decision about end-of-life care.

Document diligently

It’s important to take notes about all of the conversations you have with family members about end-of-life care. This not only makes it easier to keep track of everyone’s preferences, but can help you avoid any miscommunications later down the track. These documents can also prove useful in the unfortunate situation you ever end up in family court.

You may want to consider designating a family member to take notes of the discussions (preferably someone who isn’t directly involved in the negotiations.) You may also be able to use a recording app on your phone which will automatically transcribe the conversation for your records. Just be sure to let everyone know you will be recording.  

Consider mediation

If getting everyone on the same page is proving to be an impossible feat, there’s no shame in seeking meditation. EOL conflict mediators specialise in managing the interests of various family members and delving deeper into the underlying values, beliefs and fears behind these. These professionals can often be found employed by hospitals or hired privately. Some GPs can assist with this, too. Using a mediator to help facilitate these discussions can help your family more quickly reach a peaceful resolution.

At Scalabrini, while we can’t make your end-of-life decisions for you, we can take the time to explore your advanced care wishes with you, so you can guide us in what’s best for you.

End-of-life-planning

A guide to planning ahead for end of life

Nobody ever truly wants to think about the end of their life, or about a loved one’s passing. But, planning ahead is important to ensure that wishes are honoured and their passing can be dignified.

End of life planning ensures everyone is on the same page and eliminates the guesswork when the time does arrive.  It can also help make what is already an incredibly difficult situation slightly less stressful on the family.

Where possible, end of life planning should be a collaborative experience with your loved one. Or, if you are the one preparing for your own death, it’s important to ensure your family is aware of your wishes. 

Here, we’ve compiled some of the end of life decisions that should be considered — as well as a checklist that may help.

Make an advance care plan

Advance care planning is when an individual makes decisions about their future medical care. 

It can include information about where they would like to be cared for, any medical treatments they do or do not consent to and their desired quality of life.

When making an advanced care plan, it’s important to think about beliefs and values, as well as any specific information related to any applicable medical conditions.

Preparing an advanced care directive can help give you or your loved one greater confidence that wishes will be respected.  The idea is that this letter will be passed on to any carers or medical teams so they can make any necessary arrangements. 

Different states and governments have different forms and processes when it comes to advance care plans, so be sure to visit Advanced Care Planning Australia’s website for specific guidelines.

Consider appointing decision-makers

In the event that an individual becomes too unwell to make their own decisions in relation to end of life planning, they can appoint someone else to do this for them. 

This person would advocate on their behalf, and make any necessary decisions or arrangements.

Ideally, you will already have made all the major decisions together, but this can be helpful if anything else pops up later down the track. 

There are a few different legal appointments that can be made in this area:

    • medical treatment decision-maker – can manage your medical needs
    • enduring power of attorney – can make financial decisions
    • enduring guardianship – can make personal and lifestyle decisions

This person will generally be a spouse, family member or close friend, and cannot be a healthcare professional or paid carer. They must also be over the age of 18.

This person will be trusted with you — or, your loved one’s — life and finances. So, it’s very important to choose carefully. They should be someone you know and trust, who has a strong understanding of what you want and don’t want and is willing to communicate these for you.

Again, different states and territories have different processes for formally appointing a substitute decision-maker. However, this will generally have to be submitted through an attorney or medical care directive, so be sure to look into the guidelines in your state.

Financial planning

Money is the last thing you want to think about at the end of your life. But, it’s important to make sure all financial affairs are in order, so your family knows how to access your superannuation and insurance. 

If you or your loved one have a life-limiting illness, you may also be able to gain access these early to help maintain quality of life and provide financial support to the family.

You may want to consider hiring a professional financial advisor to help you navigate these decisions, as areas like life insurance and superannuation can be quite complex. They may also be able to help you put together for paying off any outstanding debts.

The Australian Investment and Securities Commission (ASIC) offers a free financial counselling service, if funds are tight.

Preparing your will

If you or your loved one haven’t already prepared a will, now is certainly the time. It’s also a good time to review your existing will if you have one. 

A will is essentially a legal document that sets out what will happen to an individual’s assets when they pass away. This can include physical assets like your property, cars or jewellery, financial assets like shares or savings or heirlooms with sentimental value.

In this document, you will also outline any gifts you would like to give away, and choose the executor of the will. This is the person who will be in charge of the distribution of your will after you pass. 

They will be responsible for notifying all beneficiaries of your will and distributing assets to them, as well as collecting any debts owed to you and paying any you owe, organising any necessary valuations of your assets (for example, your property) and more. 

It’s a good idea to select at least two executors in the event that one is unable to assist. As with your decision-makers, your executors should be a close and trusted friend or family member.

Preparing your will is an extremely important part of end of life planning, as, if you don’t have one, the court will decide what happens to your assets. This may cause unnecessary stress and discomfort to your family.

Planning personal matters

Many people like to ensure they have all their ‘ducks in a row’ as the end of their life approaches. This includes not only health and financial matters, but personal ones, too.

If there are any friends or people you or your loved one has unresolved issues with, now may be a good time to contact them. This step can also include deciding who you would like to have around in the final days and any religious practices you would like carried out. 

Here, you may also choose to discuss preferences for post-life care. For example, would you or your loved one prefer to be buried or cremated? Are there any specific requests for the memorial service?

Having these conversations may feel difficult or uncomfortable, but when handled with care they can actually be quite a positive experience. They can give you or your loved one the peace of mind that their passing will be as peaceful as possible. 

Here is a checklist that may help when planning.

End of life planning checklist:

Have you and/or your loved one:

    • Made an advanced care plan, including:
      • Where you would like to be cared for
      • Your preferred medical professionals or GP
      • Medical treatments you do and do not consent to 
      • Your preferences on life support

    • Appointed decision-makers, including:
      • Medical treatment decision-maker
      • Enduring Power of Attorney
      • Enduring Guardian

    • Got your financial affairs in order, including:
      • Determined how your superannuation will be distributed after you pass
      • Determined how your life insurance will be distributed after you pass
      • Created a list of all your debts
      • Created a list of all debts owed to you

    • Prepared your will, including:
      • Created a list of physical assets and how you would like these distributed
      • Created a list of financial assets and how you would like these distributed
      • Created a list of heirlooms and gifts and how you would like these distributed
      • Selected at least two beneficiaries of your will
      • Had the document legally checked and submitted by a trustee or solicitor

    • Got your personal affairs in order, including:
      • Making a plan for resolving unresolved issues
      • Communicated your preferences for end-of-life environment
      • Selected a burial or cremation for post-life care
      • Discussed funeral or memorial preferences