None of us like to think about a time when we might not be able to speak for ourselves. But the reality is that illness, accidents, or age can sometimes leave us unable to make our own medical decisions and when that happens, the people we love most are left to guess what we would have wanted.
Advance directives are legal documents that remove that guesswork. They allow you to put your wishes in writing, choose a trusted person to speak on your behalf, and ensure that doctors and healthcare teams know exactly what care you want or don’t want if you can no longer say so yourself.
At Stepping Stone Hospice & Care Services, right here in Alberton, we walk alongside patients and families through some of life’s most difficult moments every single day. We have seen, time and again, how a simple document, completed in a calm moment, with a clear mind can bring enormous peace to a family in crisis. This article is our way of sharing what we know, with the community we serve.
“An advance directive is, at its heart, a gift to your family, it spares them from having to make impossible decisions alone during an already devastating time,” Tersia Burger, Stepping Stone Hospice CEO and founder.
The key documents
The term “advance directive” is an umbrella that covers a few different documents. You may need one, or several working together.
Who needs one?
The short answer: anyone over 18. While it’s natural to think of advance directives as something only older adults need, unexpected medical emergencies can happen at any age. A young adult hospitalised after a car accident, a parent facing a serious diagnosis – all benefit from having their wishes documented before a crisis strikes.
In South Africa, you do not need a lawyer to complete most advance directives, though legal guidance is always helpful. Your document generally needs to be signed in the presence of two adult witnesses who are not your nominated decision-maker or direct heirs. Your GP or a palliative care team like ours at Stepping Stone can guide you through the process.
How palliative care and advance directives work together
Palliative care which is what we specialise in at Stepping Stone is not only about end-of-life. It is about quality of life at every stage of a serious illness. Part of that quality comes from knowing that your wishes are understood and respected.
When a patient comes to us whether to our adult in-patient unit, our dedicated children’s unit in Raceview, or for home-based care – one of the first things our registered nurses and care team do is understand what the patient and family want. An advance directive makes that conversation clearer, and ensures continuity of care across every setting, at home, in hospital, or with us.
Many people find it easier to complete the paperwork than to have the conversation. But both matter. Your nominated decision-maker needs to understand your values, not just what you have written, but why you feel that way.
Questions worth discussing with loved ones
•What does quality of life mean to me? What would make life feel not worth living?
•How important is it to me to remain mentally aware, even if it means a shorter life?
•Would I want to be kept alive by machines if there is little hope of recovery?
•Where would I prefer to be cared for – at home, in hospital, or in a hospice?
•Are there religious, cultural, or personal beliefs that should shape my care?
Our bereavement counsellors and care staff at Stepping Stone have supported thousands of families through exactly these conversations and we know how hard they can be to start. If you need help, please reach out to us. We are here not only for those who are ill, but for the families who love them.
Once your documents are completed
A completed advance directive does no good if no one knows it exists. Make copies and share them with your nominated decision-maker, your GP, any specialists involved in your care, and your nearest family members. Keep a copy somewhere accessible at home. If you are admitted to any care facility including Stepping Stone, bring your directive and ask that it be placed in your care file on arrival.
Review your directive every few years, or after any significant life change, a new diagnosis, the loss of your nominated person, or a shift in your own values. You may update or revoke a directive at any time while you still have the capacity to make decisions.
“These documents are not about giving up. They are about staying in control – ensuring your voice is heard, even when you cannot speak.”
How Stepping Stone Hospice can help
Founded in 2013 by Tersia Burger in fulfilment of a promise to her late daughter, Stepping Stone Hospice & Care Services has, since inception, cared for over 4 300 adult patients and supported approximately 40 000 family members across our community. Our philosophy is simple: you are never alone.
We are proud to be the only hospice in Gauteng to hold both CoHSASA accreditation and a five-star rating from the Association of Palliative Care Centres (APCC) simultaneously, a reflection of the clinical rigour and compassionate standards our team upholds every day.
Our services include adult in-patient care, a pioneering children’s palliative care unit (one of only five registered paediatric end-of-life facilities in South Africa), home-based care and nursing, and bereavement counselling. We serve insured and uninsured patients alike because dignity in illness should not depend on a medical aid card.
If you or a loved one would like to talk through advance care planning, or if you need palliative care support, please do not hesitate to contact us on 010 442 5059.
ALSO READ: https://steppingstonehospice.co.za/you-can-help/bequests-leave-behind-a-legacy/
