Via an Advance Care Planning (ACP) document, Mdm Chan, who has diabetes, has stated in black-and-white her wishes: “I’ve decided not to have artificial life-sustaining treatment and not to have CPR (cardiopulmonary resuscitation) if I have less than a 50 per cent chance of living. Between receiving care at home and  in a nursing home, I chose a nursing home because it has facilities and trained personnel.”

Often, family members find it painful to broach the topic with their ailing loved ones, said Mr Andy Sim, a senior medical social worker at Singapore General Hospital. “They see it as taking away hope,” he said.

Under the guidance of a facilitator at the Society of Sheng Hong Welfare Services, she has also appointed her husband as her substitute decision-maker.

The process of drafting an ACP document consists of a series of voluntary discussions on end-of-life care arrangements involving the individual, his loved ones, healthcare providers and a trained facilitator.

“There is no template. Sometimes, we try to be efficient and look for targets and deliverables,” said Dr Goh, who is from the National Cancer Centre Singapore. Patients may feel pressured, and less inclined to open up when they are presented with a form to fill up, she noted.  “People speak about (planning for end-of-life arrangements) in different ways,” said Dr Goh. “It’s not something that ends after signing the form.”

The document makes things easier for family members, said retiree Eunice Ang, 84, who did the ACP last year. “I prompted my late husband to do his too. I told him it’s good because we won’t feel guilty later. We do not know exactly what others wish for, so it’s best that they make their own choice,” said Mdm Ang, whose husband died of cancer in 2012.

Published in TODAY on 30 May 2015
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