MY eldest brother has just died. Richard, or Richie as we knew him, gave up smoking 20 years ago. But the damage was done. The regular calls in winter to the paramedics meant he needed to move from home to a nursing home. He went in to one when he was only 64.
The average age entering a nursing home is 85. Half the residents have some form of dementia. The annual mortality rate is around 30 per cent. Richie beat the odds because he lasted 10 years in aged care.
He had end stage COPD (chronic obstructive pulmonary disease). I'm sure Richie hated smoking but he got a job as a storeman in the early 1960s, a time when everyone stopped for morning and afternoon smoko. He had to join in. Now it's done him in.
For the past 10 winters Richard had colds and wheezed. This last time was the worst. He started calling 'Help me. Help me'. He went into hospital and was put on morphine and tranquillizers. I fed him a bowl of soup. It was the last meal he ever had.
He lost the ability to swallow. A palliative care specialist was called in. His job was made easier because Richie had written he was 'not to be intubated or any other extraordinary measures taken'. He had what is known as 'a good death'. There was no pain.
Fewer than one in seven Australians has an advanced care directive. Because Richard had one he didn't spend his last days in intensive care being given costly and futile treatment.
According to a recent article in the journal BMJ Open we spend, or rather waste, $153 million a year on end-of-life treatments that provide no benefit.
The new medically assisted dying law in Victoria only affects a tiny fraction of the population. People haven't won the general right to choose when they end their life. But we all have the right to say how we want our life to end.
We need to have the discussion with our GP and our family and then write our wishes down.
When asked, nearly three-quarters of us say we want to die in our own home. Only one in seven Australians will.
So write down what you want. Make it your New Year's resolution. While you're at it, update your will and power of attorney.
The ageing of Australia means the number of deaths will double in the next 25 years.
If you want to die in your home or a hospital room surrounded by family, not in an intensive care ward surrounded by machines, do something about it.
If you do, you will save your family awful worries, and help save the health system billions.
I learnt that from my brother. Thank you Richie.
Ian Henschke is chief advocate at National Seniors Australia, a leading advocacy organisation for older people. He wrote this article explaining how having an advanced care directive enabled his brother to have a "good death".
