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I'm An Actress, Comedienne, Teacher, and Show Host Who Has Done My Advance Care Planning. AMA!

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Abigail Chay profile picture
Abigail Chay
VIP 146 days ago


Hello, DoctorxDentist community! I’m Abigail Chay, a freelance actress, comedienne, teacher, and show host from Singapore! I’ll be replying to all your comments on Thursday, 4 April 2019, at 1 pm. 

Recently, there was a health screening conducted at a Residents' Committee (RC) centre in my neighbourhood. Prior to that, I had been hospitalised and I thought I was going to pass on then. The representative I met at the ACP booth was friendly and comprehensive in explaining what ACP is all about.  

Advance Care Planning (ACP) is a process that involves reflecting and sharing your care preferences with your loved ones and/or healthcare professionals in advance, so that they know what to do in the event that you lose the mental capacity to make decisions on your own.
 
I have completed my Advance Care Planning because I saw the importance of doing so for the sake of my 92-year-old father. In the event that I am hospitalised and if I can't make decisions for myself anymore, my father need not be stressed making emotionally painful decisions on my behalf. My ACP is a kind of love for my aged father should I meet death. I also managed to convince my father to do his ACP joyfully and willingly as well. 

I am an ambassador of Let's Talk Care, a Singapore-based campaign to raise awareness about Advance Care Planning. The campaign is run by four undergraduates from the Wee Kim Wee School of Communication and Information, Nanyang Technological University.  

Leave a comment below to ask me anything about Advance Care Planning, e.g.: 

• What Advance Care Planning is
• Who needs Advance Care Planning?  
• What do I need to discuss with my Nominated Healthcare Spokesperson (NHS)? 
• What does Advance Care Planning involve? 
• Where can I go or who can I approach to take care of my Advance Care Planning needs?

Comments (16)

Hi everyone, I'm Xin Tian, DxD's editor. I'll be moderating this AMA. Abigail will be coming on live on Thursday, 4 April 2019, from 1:00pm to 2:00pm to answer all your questions. Feel free to start leaving your questions and comments for her below!

Hi Abigail, thanks for joining us in this AMA session! 

I understand that you were inspired to do your ACP because of recent personal experiences being hospitalised, and also for the sake of your father. I think a lot of Singaporeans might not be aware of the ACP or even if they are aware, they might think it is something that they can do 5 or 10 years down the road, and not now.

1. How old do you think someone should be when they make their first ACP arrangement?

2. If you make your ACP arrangements when you are younger, but your life circumstances change later (e.g. you get married or divorced, your beneficiaries pass away, or you gain new children, nephews, or nieces whom you would like to support), can you change your ACP arrangements? 

3. What are some qualities you think people should look for in a Nominated Healthcare Spokesperson? E.g. ability to communicate well with healthcare staff?

Hi Xin Tian! Thanks for hosting this AMA and for inviting me and Let's Talk Care! Here are some answers to your questions: 

1. How old do you think someone should be when they make their first ACP arrangement?

In my opinion, anyone can do an ACP. I feel that as long as a person is of sound mind, understands about life and is matured enough to do an ACP, they can do their ACP. In fact, I encourage people to start considering about ACP because from my own experience, it has been a very uplifting experience for me. 

2. If you make your ACP arrangements when you are younger, but your life circumstances change later (e.g. you get married or divorced, your beneficiaries pass away, or you gain new children, nephews, or nieces whom you would like to support), can you change your ACP arrangements? 

Yes definitely! It’s especially important to update when your health conditions change, as certain health conditions may qualify for a different type of ACP where the questions may be more specific to your health condition. When you do your ACP with a facilitator, your care preferences will be documented in your healthcare records. Should your preferences or life circumstances change, you can update your ACP by going through the same procedure of scheduling an appointment with a trained ACP facilitator and your Nominated Healthcare Spokesperson. Do make sure to let your loved ones know that you have updated your ACP as well!

3. What are some qualities you think people should look for in a Nominated Healthcare Spokesperson? E.g. ability to communicate well with healthcare staff?

Ideally, your NHS should be at least 21 years old, who is someone very close to you and dear to you, and someone you can trust. For example, your best friend or sibling or your spouse can also be your NHS. Some other qualities that you should look for in your NHS is that he/she is willing to be your voice. This means that he/she is comfortable with making decisions for you. He/she should also be someone who understands you well, and knows your preferences, values and goals, and is willing to respect your care wishes in making decisions. 

Understandably, sometimes family members or friends may think differently from you, so it is important that they understand your wishes and respect them. It’s also good to find someone who can make decisions under stressful circumstances because it can be stressful and burdensome to make decisions in medical emergency situations so he/she should ideally be someone who can handle it.

Serene
143 days ago
Hi Abigail, I was wondering how much it costs to make my ACP arrangements, and how easy or difficult it is? Thank you!

Hi Serene! ACP is neither difficult nor easy, it depends on how prepared or open you are to speak about your care preferences! As for me, the whole session was very easy and full of laughter with no tension. My dad and I laughed throughout the whole session, because the facilitator was very friendly and jovial. I enjoyed the session and found it stress-free. 

If you would like to do your ACP arrangements with a trained ACP facilitator, the costs may vary. Some are chargeable and some are free among the different ACP providers. You may do your ACP at most public hospitals, polyclinics, and some community partners. I would recommend that you refer to this list of ACP providers here: https://livingmatters.sg/ACP-Directory/ and call to enquire about the cost and to schedule an appointment. 


However, you can also share your care preferences informally with your Nominated Healthcare Spokesperson through the Living Matters reflection workbook which you can download at https://livingmatters.sg/resource-library/. This will help you to guide the reflection of your preferences. 

Min Li
142 days ago
Hi Abigail!


What was your experience like doing ACP? How did you feel?

Hi Min Li! My whole experience of doing ACP was very pleasant. I found out about ACP at a public outreach where I was approached by a facilitator. After speaking to him and learning about ACP, I decided to make an appointment.

My whole process of doing ACP was very relaxing and comfortable and there was a lot of laughter. Because of this pleasant experience, I convinced my father to do his ACP by telling him that his own ACP session would be as pleasant and that it would be just as relaxed, laughter-filled, and stress-free.

Casey
144 days ago

Hello Abigail!
I was wondering what the difference between making an ACP and making a will is. Thank you for speaking about Advance Care Planning!

Hello Casey! The main difference between ACP and making a will is that ACP takes effect when one loses the mental capacity to make his or her own decisions, but a will only kicks in after one’s death.

To me, ACP is like making a will that is pertaining to my medical side of things.

For example, if something happens to me, having done my ACP, I won’t cause stress to anyone in my family since they know what care preferences I want.

Whereas for a will, it encompasses my assets, for example: who I want my assets to be given to and where. 

Jian
144 days ago
Hi Abigail! When you were planning your Advance Care Planning arrangements, what are some situations that you would plan for, or that a person should plan for?

E.g. inability to speak? unconsciousness?

Thank you!

Hello Jian! I did my General ACP, and have planned for some situations and whether I would want any life-sustenance: 

  • If I meet with a serious accident and I am in a coma
  • If I suddenly have a heart attack, and there is a very slim chance that I can be revived

For a general ACP, the person would be planning for his or her care goals (for example, to what extent would he or she would want to prolong life with the use of life-sustaining measures) in the hypothetical scenario posed of suffering a severe neurological injury where one has lost the ability to make decisions and is sick and unlikely to recover. The person would also explore his or her personal values (e.g. religious or cultural) for the quality of life. 

For a disease-specific ACP, the person would decide on specific disease-related care and determine what treatment preferences should be followed if complications result in outcomes such as a low chance of survival, or low chance of recovery of physical function or ability to communicate.

Lastly, for a preferred plan of care ACP, the person would decide on care goals on medical intervention in the event of a potentially life-threatening crisis, care options on CPR, as well as a preference on place of care and place of death.

All ACPs explore the concept of “Living Well”, which is to think about what activities or experiences are most important for one to live well and what gives one’s life meaning. It also includes what fears or worries one have about illness or medical care. 

For a more structured and detailed discussion, I would recommend booking an appointment with your preferred ACP provider (https://livingmatters.sg/ACP-Directory/) and speaking to a trained facilitator who will guide you through the different scenarios based on your needs. Thank you!

Tim
143 days ago
How can I convince my loved ones about the importance of ACP?

Hello Tim! In my own experience, I convinced my father to do ACP by making him feel very comfortable. It’s important to find the right place and right time, maybe over a meal. It can be in a nice place in a restaurant, where you can bring up this topic.

I told my father that ACP is something nice and happy. I told him that doing ACP makes it convenient for him and that I brought up the conversation because I love him. 


Hi Abigail,  where do we go do this ACP, how much does it cost and how will soon will it be effective and who are the people executing it?

Hi Roger, to do your ACP with a trained ACP facilitator, you may go to selected public hospitals, polyclinics and community partners. Do note that some charge a fee while some are free. To call to enquire about the cost and to schedule an appointment, refer to this list of ACP providers here: https://livingmatters.sg/ACP-Directory/.The people who will be conducting your ACP discussions would be trained ACP facilitators. 

It would be good to bring along one’s Nominated Healthcare Spokesperson (NHS) to the discussion so that he/she is aware of the care preferences. This is so that the NHS will be able to speak on one’s behalf in the event that he/she loses the mental capacity to make his/her own decisions. If he/she does not have an NHS, his/her care preferences will also be documented in his/her healthcare records so that medical professionals such as doctors or nurses will be informed of these preferences should he/she be hospitalised.

Thank you so much, Abigail, for answering the DoctorXDentist community's questions about Advance Care Planning, what is involved, and how to look at it positively with our loved ones! 

To learn more about Advance Care Planning, do follow Let's Talk Care on Facebook! And tell a friend! 

Thank you, Xin Tian, for having us! It's our honour, pleasure, and our joy! :) 
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