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Planning for illness and death: don’t wait, act now!

What happens if I fall ill, can no longer make decisions for myself, or die? Questions around planning for illness and death that you’d rather not think about but really should.

Text, photos and videos: Nicole Krättli

Although many people wish they’d made a will, drawn up an advance healthcare directive (living will) or appointed a proxy a long time ago, they often end up procrastinating. It’s no wonder. These can be unpleasant questions to think about. They have to do with the shadow side of getting old, serious illness, and your own death. But if you do address them and formulate your wishes and preferences, you can make sure that if the worst comes to the worst, your interests will be respected.

Living wills: in case of a medical emergency

In an emergency do you wanted to be reanimated and artificially ventilated? Do you want to be fed artificially if you can no longer swallow your own food? This is just some of the information that a living will (often known as an advance healthcare directive) can contain. A living will comes into play if medical decisions have to be made but you’re no longer capable of expressing your wishes.

“One of the key questions addressed in a living will is at what point you no longer want to receive certain types of treatment. This is a serious question that many of the people who come to us for advice have trouble with,” explains Hubert Kausch, who’s responsible for living wills at the Swiss Red Cross in Zurich.

The precise kind of living will that’s best for you will depend on whether you’re healthy or ill, and whether you want to decide on as many different matters as possible yourself or would rather leave it to another person you trust. Writing or filling out an advance healthcare directive means understanding difficult matters and requires a lot of knowledge about medicine and ethics. So it’s worth getting expert advice (see box).

For Claude Cao, chief consultant in general internal medicine and nephrology at the Hirslanden Clinic, it’s also very important to discuss these matters with members of your family and caregivers: “Death is often a taboo subject. But it’s still important to talk about it with those close to you and let them know how many and precisely which life-preserving measures you want to be taken in an emergency - and of course what you don’t want.”

Power of attorney: for life and death decisions

If someone becomes mentally incapacitated and incapable of judgement, they need a proxy to make far-reaching decisions on their behalf about things like their living situation, caregivers, their income, assets, and many other legal matters. If you haven’t appointed someone you trust as your proxy, the Child and Adult Protection Authority (KESB) will provide a proxy for you. So it’s important to think about who could assume this important role.

You can then appoint a proxy in a power of attorney written by hand and signed or notarised. Michael Allgäuer, president of the City of Zurich KESB, recommends not waiting too long to draw up a power of attorney: “Naturally this document is more likely to come into play for older people, for example those with advanced dementia; but even a young person can suddenly become incapacitated, for example because of an accident.” 

Wills: for your survivors

In Switzerland there’s basically a statutory order of succession that includes the descendants and spouses or registered partners of the deceased. If there are no descendants, parents, grandparents or the state are in line. Unmarried couples and patchwork families in particular, but also people who only want to leave the statutory minimum share to their legal heirs and pass on the rest to another person or organisation instead, can set down their wishes in a will.  It can be handwritten, dated and signed.

If it’s important to you precisely how you’re buried, you should make sure to set this down in a separate document, as the will itself often isn’t opened until after the funeral. It’s best to also make your wishes known to a trusted person. Only that way can you be sure that your relatives really know what you want. “If you don’t want to deal with this, you should at the very least tell your relatives that they’re free to decide in an emergency.  That way they know that they can’t make any wrong decisions,” advises retired undertaker Rolf Gyger.