Swansong: South Africa’s first online living-will service launches to support the need for advance care planning 

Digital living-will start-up, Swansong, has recently launched in order to make the difficult conversations about illness, facing death, and planning a good life to the end easier.

First-to-market in South Africa, Swansong offers virtual, guided end-of-life conversations and planning with expert counsellors. Over two one-hour online video sessions, a counsellor helps a client discover, clarify and communicate what is important to them towards the end of their life, documenting all of it into a living will or advance care plan.

The Swansong Advance Care Plan is legally sound, and contains the client’s decisions around future medical care (the treatment they are prepared to receive and where they want to die – hospital, hospice or home), and the nomination of their healthcare proxy (someone who can legally make healthcare decisions on the client’s behalf if they can’t). It’s a comprehensive, personalised guide that gives peace of mind to the client, and their loved ones. It can also protect clients and their families from panicked end-of-life decisions that waste financial resources.

Swansong is the brainchild of South African women, Dr Linda Holding, a palliative care-trained doctor with 20 years of clinical risk management experience, and Shivani Ranchod, a healthcare actuary and academic.

“The recent COVID pandemic has shown us that being prepared for your death is more than simply having a Will in place which details how your finances and property will be split up. Too many people were dying in a way that they wouldn’t choose for themselves,” says Holding.

One of the most valuable gifts someone can offer to those they love is to embrace their mortality and be specific about the care they do or do not want to receive, and how they would prefer to die. By planning their end-of-life wishes ahead, they’ll unburden their family from making tough decisions when the time comes someday.

Says Holding: “To all healthcare practitioners caring for the elderly or ill, we’d say you have a critical role to play in nudging your patients to think through their individual end-of-life wishes. Your patients should certainly have an advance care plan in place. Perhaps you are comfortable to have this discussion with your patients, and ensure their wishes are documented and easily accessible. However, perhaps with the pressures of running a busy practice or care home, you may not be broaching this difficult topic with your patients as often as you like, and not having the conversation in sufficient detail, nor ensuring that it is captured in a legally sound document.

“This is where Swansong can assist, by having the difficult conversations with your patients about illness, facing death, and planning a good life to the end. We have specialist counsellors who facilitate the advance care planning process.”

Swansong Project Lead, Janine Rauch, says that international studies show that *92% of us say that talking about our end-of-life values is important, yet only 32% of us have actually done so. “It’s a challenging topic to contemplate, let alone plan and discuss,” says Rauch. “Working through and documenting an advance care plan with Swansong now, especially at an older age, is a good idea. Accidents happen. Illness and surgeries increase our risk of needing an advance care plan.

“Swansong wants to help everyone think about, talk about and document their wishes for care through the end of life, so that those wishes can be understood and respected. And we know that families of people who have had a written advance care plan in place are left feeling less guilty, uncertain and bereaved after a death. If doctors and care homes routinely invite Swansong to do planning with each patient and resident, those advance care plans will reduce stress, for everyone, in the end,” says Rauch.

*Source: The Conversation Project National Survey, 2018

For more information: www.swansong.life

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