Planning for the future

Thinking about life insurance, wills and funerals probably isn’t how you and your family want to spend your time. But discussing practical matters openly and early, before a health crisis happens can make everyone feel a bit more at ease. You can be sure that your wishes for end-of-life care are understood. And it can relieve some of the stress and uncertainty for your caregivers and family.

Make sure your family knows where they can find your important documents, such as your advanced healthcare directive and will. This will make it easier if they need to use them. Taking control of these documents is not about having cancer – it’s something all adults should do.

Keep your originals in a fireproof box or a safety deposit box or with your lawyer. If you keep your important papers in a safety deposit box, make sure that a family member or friend has access to the box. Give copies of the documents to family members or healthcare professionals.

If you didn’t have life insurance before you were diagnosed with cancer, you may wonder if you will be able to get insurance in the future.

Private life insurance companies will sometimes insure people who have had cancer. It depends on the type of cancer and how far advanced it is. Talk to an insurance broker who has experience in finding insurance plans for people living with cancer. They will be able to explain which options are available to you and help you make the best choice.

All adults should have a will and keep it up to date. Having a will is one of the best things you can do to protect yourself, your partner and your family.

A will gives legal instructions about how you want your money, property and other assets to be handled after your death. It can also include information about who will look after your children (under age 18) if you die. You may also want to include who you want to look after your pets. When writing a will, get advice from a lawyer to make sure that the document is legal.

You may want to change an existing will or create a new one. Once it’s done you may feel relieved to have taken care of an important task. You can always update or change it later by talking to your lawyer.

All adults should think about the type of healthcare and personal care they would like to have in their future. It’s important for everyone – not just people with cancer – to plan for this and tell their loved ones what they would want. This process is called advance care planning. Your decisions are called advance directives.

Part of advance care planning is choosing someone to be a substitute decision-maker for you, if necessary. This person needs to be someone you trust and who understands your values. Your substitute decision-maker needs to understand what you want because doctors and nurses will ask this person to make decisions about your healthcare if you can’t. This person can also be known as your power of attorney for personal care, which means they have legal authority to act for you on your behalf when you can no longer speak for yourself. (You can also choose a power of attorney to make financial decisions for you.)

It’s normal to want to avoid talking about subjects like how you feel about breathing tubes or when you would no longer want a treatment that is keeping you alive. Making plans might make you feel like you’re giving up on your treatment or yourself. You’re not. You’re just doing your best to think ahead for yourself and for your loved ones.

It’s important to talk about:

• the use of breathing machines or ventilators
• the use of CPR (cardiopulmonary resuscitation) if breathing or heartbeat stops
• artificial feeding such as tube feeding
• continuing or not continuing with medical treatments

Many hospitals have a policy of asking people if they want CPR to try to revive them if their heart or breathing stops. If they don’t want CPR, the person can agree to a DNR (do not resuscitate) order or No CPR order, which is written in their medical chart by their doctor. It may be called different things in different hospitals, so it’s best to ask.

As long as you can speak for yourself, healthcare professionals will speak directly with you about what you want in terms of your care. But there may be a time in your life when you can’t speak for yourself. At that time – which may have nothing to do with cancer – having an advance care plan will make sure that your wishes are followed.

By thinking about these topics and telling your loved ones what you would want in different situations, you will make things easier for them if they ever have to make decisions for you. Knowing that your wishes are understood can make you feel relieved and less stressed.

The decisions in your advance directive should be written down, and the originals need to be kept somewhere safe. You can also give copies of any legal documents related to medical care to your doctor or other members of the healthcare team. Many people worry that once things are written down, they can’t change their minds. But advance care planning can still be talked about and you can make changes to the plan.

Laws about advance directives differ from province to province. It’s best to talk to a lawyer or your healthcare team for more detailed information.

All adults should think about preplanning their final arrangements. Not everyone is comfortable doing this. But if you can, it means that your family or close friends won’t have to make these decisions when they are grieving and have little time to think them through. Knowing that your wishes will be carried out can also bring you a sense of peace. Deciding on your final arrangements can include decisions about:

• whether you wish to be buried or cremated
• if you would like your ashes to be buried, scattered or kept by loved ones
• your wishes for a funeral, memorial service or something else, where it should be held and any special instructions for it

If you’re ready, talk to a funeral director, spiritual advisor or social worker. Share your decisions and plans with family members and keep a copy of documents related to final arrangements with your other important papers. If you have special wishes related to any religious, spiritual or cultural practices around dying or after death, make sure caregivers and the healthcare team know about them.

If you don’t want to make detailed final arrangements, you should still let loved ones know whether you prefer to be buried or cremated.

It is possible to be an organ, tissue or body donor after your death even if you’ve had cancer. It will depend on the cancer type and medical condition of the organ or tissue and whether the cancer had spread to other parts of the body.

All organs and tissues considered for transplant are tested carefully to make sure they are suitable for donation. This is done to protect the health of any person who receives the organ or organs. For more information about organ or tissue donation, contact the organ or transplant program in your province.

Most medical schools or research facilities have a process in place to accept body donations, but you need to make the arrangements before death. Contact the institution where you would like to donate your body for the requirements.