How do I help someone with their last wishes?

People have different ‘last wishes’ in their final days. A person’s wishes can be personal, cultural or legal. In this article, ‘wishes’ are anything a person prefers, wants or expects at the end of their life.

Some wishes are easier than others. Some wishes may not be possible due to the person’s condition or the complexity of the wish.

Communication and planning

Communication and planning are essential. It is important to discuss with the person, as well as their healthcare team, such as their GP, treating team and palliative care team, as early as possible.

Last wishes are different for everyone, and they can change with time.

Listening is key

You can also give someone the chance to talk by asking them questions. Remember, starting conversations is about giving them an opportunity to talk. If they don’t want to talk, that's okay. Let them know you are there for them when they need you.

Documenting the person’s wishes

In Victoria, the government has set up a formal advance care planning system for people to express and document their wishes. It has free, standardised paperwork and doesn’t need a lawyer. The process involves making a plan for a person’s medical and personal care, known as an advance care directive. The advance care directive is designed to be used if that person is ever unable to communicate or make decisions. It also involves nominating representatives for the person, to aid in communication.

There are other useful ways to let people know about your wishes, such as conversations with friends, family or your healthcare team, or other written documents. Palliative Care Australia has a range of discussion guides to help people talk about and write down their wishes, preferences and values. What’s most important is expressing your wishes so that people know what they are and can act on them.

How to carry out someone's wishes

The person’s health care team can help. Palliative care nurses are specialists and know what can be achieved, what is realistic and how it can be achieved.

The Victorian Palliative Care Advice Service can also help. It is free and available for anyone to call and speak with a palliative care nurse who can help with specialist guidance and advice.

In a hospital or palliative care unit (hospice), you might need to ask, even if you think something might not be possible.

Why some wishes are not carried out

When someone’s preferences or expectations aren’t met or respected, it is usually despite the best efforts and intentions of everyone involved. A common reason for someone’s wishes not being carried out or respected is that they haven’t expressed their wishes sufficiently. Completing an advance care plan is a very effective way of having important discussions and documenting the wishes.

Another common reason for wishes not being carried out or respected is when communication breaks down between the various people involved in the person’s care. You can help this by making sure advance care planning is complete and copies of the advance care directive are kept in as many places as possible, including given to the GP, residential facility manager and Ambulance Victoria, and uploaded to MyHealthRecord.

Another reason for wishes not being carried out or respected is lack of planning. Unforeseen situations can ruin plans. For example, when fulfilling a wish requires transport, a barrier is often the medical transport service’s policies. Make sure the practical aspects, such as transport, are planned ahead of time.