How to build a care plan that caters to a traumatic death

Jun 17, 2023 | Advance Care Planning

The great hope for all of us is that we die peacefully in our bed, surrounded by love. It’s not a bad dream to have. But sometimes, life and death have other plans for us. That’s why it’s important to build a care plan that looks at the specific considerations related to a traumatic death.

Whether you are in a high-risk profession or simply someone who understands the nature of accidents happening, thinking about a traumatic death and it’s impact on your loved ones may not feel like the cheeriest way to spend a week, but it can help create a safety net and support the grieving process for those left behind.

Here are some considerations for you when designing your ExSitu care plan to cater to a traumatic death event

What is a traumatic death?

A traumatic death is a sudden, unexpected, and/or violent death. They lack the anticipation that comes with someone dying from illness, disease or old age, often creating shock due to the age and manner a person dies.

Traumatic deaths are most likely caused by:

  • The actions of another person – intentional or otherwise. E.g. murder, act of war, reckless actions etc
  • An accident – this can include vehicle, workplace, activity-based, or other form of accident
  • Suicide, suicide attempt or an act of self-harm that leads to death without suicide as the intended outcome (e.g. disordered eating, drug overdose, risk-taking behaviour
  • Natural disaster – such as flood, fire, earthquake etc
  • Other forms of catastrophe – e.g. building collapse, freak accident, mass casualty, etc

While we may not want to consider a traumatic death in a care plan, doing so helps:

  1. Articulate your care choices and medical decisions should you sustain injuries that require intervention, especially when related to tough choices and outcomes on your behalf
  2. Reduce the trauma associated with your last moments and death by providing a roadmap to your decisions and lowering the amount of administration your loved ones may encounter
  3. With navigating your military or emergency employer, ex-pat life and culture, and so on
  4. Assign the responsibilities to people that may be better equipped to cope with losing you in a traumatic way

The emotional impact

Most care plans nominate a person who will help you execute the wishes you outline. The ExSitu care plan allows for two people. The reason we offer space for two is so that:

  1. If the person you nominate cannot fulfil duties for practical reasons. For example, during the Covid-19 country shutdowns or state lockdowns, this may have created circumstances where someone couldn’t assist
  2. If you are with the person you nominate and you both die at the same time
  3. If the person you nominate is emotionally or psychologically unable to function

When choosing a person, don’t only think of family, partner, or the person closest to you. Sometimes, the person you know and respect but may not exactly be in your inner circle can keep a cooler, clearer head.

When choosing your second nominee, consider:

  • Who is good in a crisis?
  • Who shares your values, especially in relation to quality of life and belief systems?
  • Who is good at tackling highly charged issues with a neutral or observational outlook?
  • Who is good at weighing up the pros and cons of a decision?
  • Who has the courage and conviction to make a tough call if needed?

The location of key players

Traumatic deaths can create problems for people, especially if geographic distance is a factor. You may find that it is far more intelligent to have someone living locally to run point on medical and well-being decisions and death care, especially if you are living in another state or country to your next of kin or immediate family.

For example, if you are living and working in another country with an established life and you die in an accident or unexpectedly, it’s much easier for the people left behind if they don’t have the tyranny of distance and differences in legal, medical and social decision making to navigate.

Nominating a local contact in your care plan can:

  1. Make it easier for time-sensitive medical decision making, especially if loved ones have to travel great distances or are in different time zones
  2. Expedite your return to your loved ones by giving them a person on the ground to help with arrangements and push for the things as needed
  3. Use local insight to navigate legal, spiritual or cultural requirements that may be present in providing you the care you need

When considering your local contact in a traumatic death situation, consider:

  • Who is local and/or has an in-depth knowledge of the culture?
  • Who has a good head for bureaucracy and organisation?
  • Who is the right mix of patient and pushy, so things get done in a timely fashion?

Using the care plan questions and Hierarchy of Values to suit

Some of us are far more likely to encounter a traumatic death than others. For example, high-risk occupations like emergency service personnel, if you work in mining or construction, if you spend a lot of time on the roads, or you have hobbies or work that increases the risk of falls such as rock climbing or working at height.

However, we’re all one accident away from needing a care plan or facing a traumatic death. We cannot predict if we will die from old age anymore than we can foresee tripping over the dog and falling down the stairs.

Taking the time to think about a Plan A, Plan B and even a Plan C as you build the Hierarchy of Values and your ExSitu care plan helps.

For example:

Plan A is dying of old age, surrounded by family in a relatively expected way.

Plan B may be dying after a prolonged illness such as cancer and what that might look like, especially if you lose capacity towards the end.

Plan C could involve a car accident with a high level of medical decision-making and leaning heavily on what your version of quality of life looks like at an earlier than expected age.

Each of these options has similar considerations but are not the same. Planning for each gives you roughly a better, medium and worst-case scenario.

Those scenarios can then inform:

  • Who makes your decisions?
  • Where your treatment line begins and ends. For example, how much is too much dignity lost to illness can look different when we’re younger, have been living pain-free or have more options related to medical interventions
  • If you are single, estranged from family, or have developed networks and connections in a place faraway from your family that you’d like honoured, what will happen after you die?
  • The reactions and responses of the people who love you and what they need
  • The financial choices you would make in relation to care and burial
  • What happens to your children, pets, and other dependents – and how much of the experience of your traumatic death you believe is appropriate to share with them?

By choosing to cover the ideal to the unwanted scenarios helps create a blueprint of your choices along with what you value the most. This kind of thinking helps cover more territory than focussing on a life ending peacefully with old age.

The last word with care plans for traumatic deaths

Most people avoid a care plan until they enter old age. This creates a minefield when you have nothing planned when accidents or misadventure occur. It doesn’t mean you will need to activate the traumatic death portion of your care plan. However, it serves as a great boundary line for the moments when the chips are down or if your circumstances rapidly decline.

And remember, a plan is just a plan. You’re not inviting the Grim Reaper over to disco dance in risky circumstances and see where you land. You’re simply planning for difficult circumstances as an act of sparing the ones you love from as much pain and trauma as you can. That’s an enduring gift that helps create the conditions for supporting you and supporting each other.

If you need help to get your ExSitu care plan together, book an online facilitation now.

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