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UBC Theses and Dissertations

Preplanning & older adults : opportunities for education Taylor, Joanne Patricia


Statistics reveal that only a small percentage of the older population is likely to experience mental incapacity due to illness, disease or accident. Yet, older adults greatly fear such circumstance and the repercussions that may follow — namely a lack of control over decisions about their person and their affairs. Preplanning for possible incapacity or future need of assistance can relieve such fears and will enhance independence and autonomy should an individual experience temporary, gradual or permanent loss of ability to manage her affairs. Preplanning involves choosing a person or persons to represent one's values and wishes if assistance is needed. Types of assistance may include making decisions about health care treatment, paying bills or signing consent for entering (or leaving) a facility. Interest in preplanning is growing. This thesis highlights some of the factors influencing this interest. Among them is the implementation and imminent proclamation of British Columbia's new adult guardianship legislation, specifically the Representation Agreement Act which provides for a comprehensive preplanning tool. This qualitative study explored older adults' perceptions of and experiences with preplanning. Individual and group semi-structured interviews were conducted with 12 adults over the age of 65. Although participants comprised a small and nonrepresentative group, their perspectives provided insight into the meaning of preplanning to some older adults and pointed to opportunities for informational and educational initiatives on the topic. Participants' experiences indicated that formal and legal procedures to document one's choices are the final step in preplanning efforts. Yet existing education and information focus exclusively on this aspect of preplanning. Research results identified numerous other, and more important, issues that require attention. One of the necessary elements for successful preplanning is the existence of trusting, personal relationships. Those who lack such relationships are extremely vulnerable to public guardianship, that is, to becoming a 'file' or a 'case' among many others in the system. Lack of access to natural sources of support such as a spouse, children or friends, means there is no one to represent the person and her wishes if assistance is needed. The challenge is to connect isolated older adults with individuals and groups in the community and thereby facilitate opportunities for them to develop personal relationships. This study concludes with the proposal that educational initiatives must include a community development component if preplanning is to be accessible to all older adults. Particular attention is given to the role of community associations, especially those led by older adults, in implementing this approach. Specific recommendations highlight the value of peer counsellors in supporting individual preplanning efforts. Recommendations also call for the need to expand the places and times where education on preplanning occurs including where people seek health services, when people make arrangements for their will or burial/cremation and when people are engaged in retirement planning.

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