Document de Voluntats Anticipades, com fer-lo al CAP

A Ràdio Maricel, cada dia, al matí, amb nosaltres.

At Ràdio Maricel, every day, in the morning, with us.

A les 10 i 21 és hora de Medicina Comunitària.

At 10:21 is the time for Community Medicine.

A aquest espai que fem els divendres de manera quinzenal,

To this space that we hold on Fridays biweekly,

en col·laboració amb tots els professionals del Centre d'Atenció Primària de Sitges,

in collaboration with all the professionals of the Sitges Primary Care Centre,

del CAP d'aquí del municipi, i avui parlarem del DBA.

from the healthcare center here in the municipality, and today we will talk about the DBA.

No sé si saben què és això del DBA.

I don’t know if you know what this DBA thing is.

Potser el sona, potser l'han sentit a parlar.

Maybe it sounds familiar to you, maybe you have heard people talk about it.

És el Document de Voluntats Anticipades.

It is the Advance Directives Document.

És un document que es facilita, s'ajuda a tirar endavant

It is a document that is provided, it helps to move forward.

des del CAP i en volem parlar perquè probablement és un tema

from the health center and we want to talk about it because it is probably a topic

que agrada poc tocar i parlar perquè d'alguna manera té a veure

that it is not very pleasant to touch and speak because it relates in some way

amb el final de la vida, amb aquelles situacions en què probablement

with the end of life, with those situations in which probably

no ens hi voldríem veure ningú, però que sabem que de vegades arriben.

We wouldn't want to see anyone there, but we know that sometimes they arrive.

I es tracta, sobretot, de poder programar allò que un vol o no vol

It is mainly about being able to schedule what one wants or does not want.

arribar a un moment en què es té incapacitat per decidir.

to reach a moment when one has the incapacity to decide.

Per parlar-ne de tot plegat, ha vingut avui aquí a l'estudi

To talk about all of this, he has come here to the studio today.

la treballadora social sànica.

the social worker sànica.

Comitària, Raquel Morciego.

Committee member, Raquel Morciego.

Hola, Raquel, bon dia.

Hello, Raquel, good morning.

Hola, bon dia.

Hello, good morning.

Que la gent, en general, en sabem la ciutadania, que és el DBA.

That people, in general, know what citizenship is, which is the DBA.

N'hem sentit a parlar o què?

Have we heard him talk or what?

Doncs mira, jo porto tres anys aquí al municipi i sé i puc dir que des de tres anys cap aquí

Well, look, I have been here in the municipality for three years and I know and can say that for the past three years...

la gent va aprenent el que és el DBA.

People are learning what a DBA is.

Cada vegada més, no?

More and more, right?

Cada vegada més.

More and more.

És important?

Is it important?

És molt important.

It's very important.

Fins a quin punt?

To what extent?

És a dir, perquè jo ara deia, clar, en general, en general, la ciutadania,

That is to say, because I was just saying, of course, in general, in general, the citizenship,

parlar del final de la vida, no?, i d'allò que no ens agrada.

talking about the end of life, right?, and about what we don't like.

Llavors mirem de girar-nos d'esquena i dir, si no em parles no ha de passar.

Then we try to turn our backs and say, if you don't talk to me, nothing has to happen.

Exacte, si no em parles, si no em toca, doncs millor, no?, i així no ho miro i no passarà.

Exactly, if you don't talk to me, if you don't touch me, then it's better, right? And that way I won't look at it and it won't happen.

Però justament aquest document el que t'obliga una mica és a plantejar-te possibles situacions, no?,

But precisely this document is what compels you a bit to consider possible situations, right?

posar-te en situacions hipotètiques, no?, per evitar després entenir problemes, oi?

putting yourself in hypothetical situations, right?, to avoid encountering problems later, right?

Clar, no sabem mai el que passarà, però sí que és veritat que ens diu o ens fa pensar

Of course, we never know what will happen, but it is true that it tells us or makes us think.

si passessin, depèn de quines circumstàncies, com s'hauria de...

if they happened, depending on what circumstances, how it should be...

de mantenir.

to maintain.

És un document que el que fa bàsicament la ciutadania, la persona, és expressar i deixar per escrit, entenc, no?,

It is a document in which the citizen, the person, basically expresses and leaves in writing, I understand, right?

les voluntats d'aquella persona, d'ell mateix, arribats en segons quines circumstàncies.

the wishes of that person, of himself, reached under certain circumstances.

Això es pot fer tot a través del CAP?

Can this all be done through the health center?

Es pot fer tot a través del CAP.

Everything can be done through the CAP.

Hi ha tres maneres de fer-ho, molt bàsiques.

There are three ways to do it, very basic.

La primera és davant d'un notari, on també la notaria té un conveni especial amb Salut,

The first is in front of a notary, where the notary also has a special agreement with Health.

on acaba registrat a la història de cadascun dels pacients,

it ends up being recorded in the history of each patient,

i després hi ha dues maneres de fer-ho, que les dues es poden fer a través del CAP.

And then there are two ways to do it, both of which can be done through the health center.

Una és amb tres testimonis, que poden ser tres persones que coneixen aquesta persona

One is with three witnesses, who can be three people who know this person.

que fa el document de voluntats anticipades,

what the advance directives document does,

o només han de testimoniar que està bé cognitivament com per poder-ho fer,

or they only have to testify that he is cognitively well enough to do it,

i sí que és veritat que d'aquestes tres persones només una pot ser família directa

And it is true that out of these three people, only one can be a direct family member.

o pot tenir un vincle directe,

or it can have a direct link,

i l'altra, que és la nova,

and the other one, which is the new one,

que és la que va sorgir a través d'un canvi o d'una modificació de l'Ajuntament,

that is the one that emerged through a change or modification of the City Council,

que és com a testimoni un professional sanitari,

who is serving as a witness, a healthcare professional,

que professional sanitari pot ser metge o infermera.

a healthcare professional can be a doctor or a nurse.

És a dir, aquest canvi legislatiu, que va ser fa poc, a l'abril del 2024,

That is to say, this legislative change, which was recently, in April 2024,

permet que per fer aquest document, en comptes de portar aquestes tres persones,

let's say that to make this document, instead of bringing these three people,

de les quals només una pot ser un familiar directe,

of which only one can be a direct relative,

és a dir, havies d'entrar d'alguna manera el veí, la veïna, un amic, una amiga,

that is to say, you had to somehow bring in the neighbor, a friend, a female friend,

algú que no tingués un vincle familiar, un vincle...

someone who didn't have a family connection, a bond...

Parental o de patrimoni.

Parental or of heritage.

Exacte, o de patrimoni.

Exactly, or of heritage.

Ara ho pots fer, entenc que amb un familiar i algú del personal sanitari?

Now you can do it, I understand that with a family member and someone from the health staff?

No, simplement amb un personal sanitari com a testimoni.

No, just with a healthcare professional as a witness.

D'acord, d'acord.

Alright, alright.

Una altra cosa, que després en parlem si vols, és que pugui haver-hi un o dos representants.

Another thing, which we can discuss later if you want, is that there could be one or two representatives.

D'acord.

Okay.

Però com a testimoni, només amb el teu metge o infermera es pot...

But as a witness, you can only... with your doctor or nurse.

Entenc que aquest canvi legislatiu va venir donat per una demanda,

I understand that this legislative change came about due to a demand,

per una situació del fet de...

for a situation of the fact that...

És a dir, aquesta petició dels tres testimonis,

That is to say, this request from the three witnesses,

en la qual només un podia ser algú de relació parental,

in which only one could be a relative,

entenc que això dificultava l'àcid.

I understand that this made the acid difficult.

Això dificultava, això dificultava poder-ho fer.

This made it difficult, this made it difficult to do it.

Nosaltres, per exemple, ho vèiem al dia a dia, venien a informar-se

We, for example, saw it in our daily lives; they came to inquire.

i quan li deies el dels tres testimonis deies,

And when you said about the three witnesses, you said,

ostres, a veure com ho fem, a veure a qui li diem,

Wow, let's see how we do this, let's see who we tell.

perquè clar, al final has d'explicar el que posaràs en aquell document

because, of course, in the end you have to explain what you will put in that document.

o almenys el que vols fer, i el que parlàvem abans, no?

or at least what you want to do, and what we were talking about earlier, right?

No és tan fàcil parlar de...

It's not that easy to talk about...

Perquè en aquest document què es posa? Què és el que es diu?

What is stated in this document? What is it that is said?

En aquest document, principalment, dius el que no podràs dir,

In this document, mainly, you say what you will not be able to say,

en l'última fase o en les últimes fases de la teva vida,

in the last phase or in the last phases of your life,

perquè no tindràs la capacitat per poder-ho dir,

because you will not have the ability to say it,

o per poder-ho expressar, d'alguna manera.

or to be able to express it, in some way.

Aleshores, es tracta de deixar escrit el que tu vols per tu

So, it's about writing down what you want for yourself.

en fases de la vida, en l'última fase de la vida.

in phases of life, in the last phase of life.

Es pot donar la situació que puguis expressar-ho fins a l'últim dia,

It is possible that you can express it until the last day.

però si es donés el cas, com que és poc previsible,

but if it were to happen, since it is unlikely,

o imprevisible, podríem dir,

or unpredictable, we could say,

el que fas és com avançar-te en una hipotètica situació

What you are doing is like getting ahead in a hypothetical situation.

de pèrdua cognitiva o pèrdua...

of cognitive loss or loss...

Diguem, de capacitat.

Let's say, in terms of capacity.

De capacitat.

Of capacity.

De capacitat d'expressió, no?

Of capacity for expression, right?

I, per tant, t'avances en aquestes situacions.

And therefore, you advance in these situations.

I, per tant, bàsicament, el que vens a dir,

And, therefore, basically, what you're saying is,

o el que es ve a dir en aquest document és

or what is stated in this document is

si vols rebre medicació,

if you want to receive medication,

o si vols que rebre algun tipus de pal·liatiu,

or if you want to receive some type of palliative,

o et dec, no? Va per aquí, eh?

Oh, you're joking, right? It's going this way, huh?

Bé, algun tema, tot un tema de medicació,

Well, some topic, a whole topic of medication,

o d'experimentació, amb tots els tractaments que hi ha ara nous,

or experimentation, with all the new treatments that are now available,

tot el tema de poder mantindre's,

the whole issue of being able to sustain oneself,

de manera artificial,

artificially,

tot el tema de sondes mecàniques,

the whole issue of mechanical probes,

de respiracions artificials,

of artificial respirations,

tot aquest tema,

this whole topic,

i, fins i tot, el document és molt ampli.

And, in fact, the document is very extensive.

El document que nosaltres...

The document that we...

Entenc que hi ha una plantilla, no?

I understand there is a template, right?

Exacte.

Exactly.

I a partir d'aquí vas...

And from here you go...

D'acord.

Okay.

El document que nosaltres oferim sempre

The document that we always offer.

és el model de la Generalitat,

it is the model of the Generalitat,

que està penjat a la web de la Generalitat,

that is posted on the Generalitat's website,

i aquest document és molt ampli.

And this document is very extensive.

Tracta diferents coses,

It deals with different things,

aquestes que ja ho hem dit,

this is what we have already said,

o fins i tot tot el tema de donació d'òrgans,

or even the topic of organ donation,

tot el tema de voluntat d'eutanàsia,

the whole issue of the will for euthanasia,

ja s'avança en aquest sentit,

it is already progressing in this direction,

i, bé, la veritat és que és molt ampli,

yes, well, the truth is that it is very spacious,

et dona una visió molt àmplia de la situació

it gives you a very broad view of the situation

i et fa pensar en coses que segurament no havies pensat.

and it makes you think about things you probably hadn't considered.

Clar, i sabem que moltes vegades no ens agrada pensar,

Of course, and we know that many times we don't like to think,

però arribada a la situació entenc que això evita molts problemes, oi?

But upon reaching the situation, I understand that this avoids many problems, right?

Això evita molts problemes i molta tranquil·litat.

This avoids many problems and brings a lot of peace of mind.

O sigui, per la persona en qüestió,

That is to say, for the person in question,

és una tranquil·litat quan el fan moltes de les persones

It is a tranquility when many people do it.

que venen a la consulta, és...

that come to the appointment, is...

Mira, ja m'he quedat tranquil·la.

Look, I am calm now.

He fet això i ja m'he quedat tranquil·la.

I have done this and now I feel at peace.

I l'altre és pels familiars,

And the other is for the relatives,

pels familiars que en aquell moment han de decidir, no?

for the family members who have to decide at that moment, right?

Han de decidir començar a assadar,

They have to decide to start rehearsing,

han de decidir desendullar, han de decidir...

they have to decide to unplug, they have to decide...

Treus el pes als familiars, no?

You relieve the burden on your family, right?

Exacte.

Exactly.

Treus un pes difícil, no?

You're taking off a heavy weight, aren't you?

Sí, sí.

Yes, yes.

O prendre decisions, o evites que familiars,

Either make decisions, or you prevent relatives,

en una situació de vulnerabilitat màxima, no?

in a situation of maximum vulnerability, right?

Perquè estàs afectat, perquè veus el teu familiar en aquesta situació,

Because you are affected, because you see your family member in this situation,

hagis de prendre decisions,

you have to make decisions,

sense que la majoria de gent que ve a fer-ho,

without the majority of people coming to do it,

i això va canviant, eh?, cada vegada es va ampliant,

And this is changing, right? It keeps expanding more and more.

però la majoria de gent que ve a fer-ho,

but the majority of people who come to do it,

és gent que ha passat per aquesta situació com a familiar, com a amic,

They are people who have gone through this situation as a family member, as a friend,

i han vist la necessitat, la duresa i la necessitat

and they have seen the need, the harshness, and the necessity

que no els hi passi als del seu voltant.

that it doesn't happen to those around them.

Perquè la majoria de gent, quan es posa a fer aquest document

Because most people, when they start to create this document

i a redactar-lo, i en aquest cas a omplir aquest formulari,

and to draft it, and in this case to fill out this form,

i en companyia vostra dels sanitaris,

and in your company of the healthcare workers,

entenc que el que preocupa més és el patiment,

I understand that what worries the most is the suffering,

és a dir, el que la gent busca, sobretot, és evitar el patiment.

That is to say, what people seek, above all, is to avoid suffering.

Sí, sí, sobretot.

Yes, yes, especially.

Aquest seria l'objectiu principal, el no patir, no?

That would be the main objective, not to suffer, right?

Exactament, evitar el patiment, però...

Exactly, to avoid suffering, but...

El patiment propi i dels altres, sobretot,

The suffering of oneself and of others, above all,

evitar el patiment propi i dels del meu voltant, sí.

to avoid my own suffering and that of those around me, yes.

Qui pot fer aquest document?

Who can create this document?

Pot fer-ho qualsevol persona adulta,

Any adult person can do it.

en ple ús de les seves facultats.

in full use of his faculties.

És a dir, a partir dels 18 anys hi podria anar qualsevol, eh?

That is to say, from the age of 18 anyone could go there, right?

Sí.

Yes.

No necessàriament ha de ser una persona gran,

It doesn't necessarily have to be an older person,

que estigués en un procés de malaltia, no necessàriament, eh?

that was in a process of illness, not necessarily, okay?

No.

No.

I no sé si hi ha un moment recomanat,

I don't know if there is a recommended time,

és a dir, si és recomanable fer-ho abans que pugui arribar a qualsevol malaltia, no?

That is to say, if it is advisable to do it before any illness can occur, right?

No, no és recomanable, o sigui, no és recomanable cap moment.

No, it is not advisable, I mean, it is not advisable at any moment.

Sí que és veritat que un percentatge molt elevat

Yes, it is true that a very high percentage

ho fan les persones grans, que ja ho veuen com a més immediat, no?

They do it the elderly, who see it as more immediate, right?

S'ho veuen més a prop, no?

They see it closer, don't they?

S'ho veuen més a prop, exacte.

They see it closer, exactly.

Però també hem tingut persones joves que ho han fet,

But we have also had young people who have done it,

per diferents motius, eh?

for different reasons, huh?

Però, home, jo crec que és una cosa que potser hauríem de fer-ho tots,

But, man, I think it's something we should maybe all do.

i potser hauríem de fer aquell parèntesis, no?,

And perhaps we should take that parentheses, right?

per pensar en el dia de demà,

to think about tomorrow,

perquè ojalà sigui molt tard,

because hopefully it will be very late,

però hi ha situacions que s'hi troben molt d'hora,

but there are situations that are found very early on,

i molt d'hora, molt sobtats,

and very early, very surprised,

i aquí tenim els problemes.

And here we have the problems.

Entenc que un cop he fet aquest document signat ja d'una manera oficialitzada,

I understand that once I have made this signed document in an official manner,

aquest document s'ha de complir sí o sí, eh?

this document must be fulfilled, right?

No hi ha una manera, i incomplir-lo,

There is no way, and to break it,

entenc que un estaria cometent delicte.

I understand that one would be committing a crime.

Ja m'hi fico amb coses de lleis que jo no soc advocada i no ho sé al 100%,

I get involved with legal matters that I am not a lawyer and I don't know 100%.

però està clar que si hi ha una llei que així ho decideix,

but it is clear that if there is a law that decides so,

en teoria s'ha de fer així.

In theory, it should be done this way.

I, en principi, està al registre del document de voluntats anticipades

I, in principle, is registered in the document of advance directives.

de la Generalitat de Catalunya.

of the Government of Catalonia.

Hi ha una història clínica de cadascun dels pacients.

There is a medical history for each of the patients.

En principi, sí, s'ha de fer així.

In principle, yes, it should be done this way.

Per tant, això, en cas que arribés una situació d'urgència màxima,

Therefore, this, in the event that a situation of maximum urgency arises,

no sé què, allò apareixeria en el registre del pacient, eh?,

I don't know what, that would appear in the patient's record, right?

en qualsevol centre.

in any center.

A veure, hem de tenir present situacions vàries,

Let's see, we need to keep various situations in mind,

i situacions vàries d'emergència i urgència sobtada.

and various emergency and sudden urgency situations.

O sigui, un exemple clar, no?

So, a clear example, right?

Tu vas pel carrer, et dona una parada cardíaca,

You are walking down the street, you have a cardiac arrest,

i vindrà la ambulància i t'intentarà reanimar.

And the ambulance will come and try to resuscitate you.

No miraran.

They will not look.

No miraran si tenen document de voluntats anticipades.

They will not check if they have an advance directives document.

T'intentaran reanimar.

They will try to revive you.

Una altra cosa és que arribis a l'hospital,

Another thing is that you arrive at the hospital,

que t'hagin quedat seqüeles,

that you have residual effects,

que això acabi en un estat vegetatiu,

that this ends in a vegetative state,

o que acabi en un...

or that ends in a...

Aleshores, es mirarà i es veurà a veure com procedir.

Then, he/she will look at himself/herself and will see how to proceed.

La immediatesa es seguirà fent.

Immediacy will continue to be done.

D'acord.

Alright.

No vindrà ningú amb el document.

No one will come with the document.

Ep, no reanimem, no.

Hey, let's not revive it, no.

La immediatesa es seguirà fent.

The immediacy will continue to be done.

Una altra cosa són les conseqüències del que et passi

Another thing is the consequences of what happens to you.

i com s'ha d'abordar en aquell moment.

And how it should be approached at that moment.

Com ha de començar?

How should it start?

Si algú que ens estigui escoltant ara diu

If someone who is listening to us now says

ostres, doncs jo crec que això ho hauria de fer...

wow, well I think I should do this...

Com ha de funcionar el procés?

How should the process work?

Doncs han de demanar cita amb mi presencialment,

Well, they have to make an appointment with me in person.

al CAP,

at the health center,

o a través de tablella, a través de trucada,

or through tablella, through a call,

com sempre, demanar cita presencial.

As always, make an appointment in person.

Jo els hi puc facilitar, si ja ho tenen,

I can provide them, if they already have it.

també perfecte,

also perfect,

els hi puc facilitar el model,

I can provide them with the model.

els informo de tots els dubtes que tinguin

I inform you of all the doubts you may have.

i després quedem

And then we meet.

per poder registrar-ho

to be able to register it

amb una... Si és en el cas dels tres testimonis,

with a... If it is in the case of the three witnesses,

quedem amb minuts més.

Let's meet in a few minutes.

Si és en el cas del testimoni sanitari,

If it is in the case of the health witness,

quedem amb una visita conjunta

Let's arrange a joint visit.

amb el personal sanitari, sigui metge o infermera,

with the healthcare staff, whether doctor or nurse,

i amb mi, per poder-ho acabar de registrar

and with me, in order to be able to finish registering it

amb l'ajuda dels administratius del CAP.

with the help of the administrative staff of the health center.

Quin és el dubte amb el que...

What is the doubt with which...

quan...

when...

les persones que venen a demanar això, no?

the people who come to ask for this, right?

Quin és el dubte més freqüent?

What is the most common doubt?

No sé si hi ha un dubte més freqüent o un neguit més freqüent, no?

I don't know if there's a more frequent doubt or a more frequent worry, right?

Que diguéssim...

Let's say...

És el que hem parlat abans, ja.

It's what we talked about before, already.

El dubte més freqüent és el patiment,

The most common doubt is suffering,

el dubte més freqüent és de persones que no ho tenen clar,

the most frequent doubt is from people who are not sure about it,

és que això no vol dir que qualsevol,

it doesn't mean that anyone,

a la primera, em desendollaran,

they will unplug me at the first chance.

no, això vol dir que tu has de decidir

no, this means that you have to decide

el que vols en aquell moment.

what you want at that moment.

I si les persones veuen el document,

And if people see the document,

veuran que a cadascuna de les parts

they will see that in each of the parts

del que parlen,

of what they talk about,

hi ha sempre un altre amb un espai

there is always another with a space

per poder explicar-ho

to be able to explain it

específicament el què.

specifically what.

O sigui, es pot detallar

So, it can be detailed.

al mínim. La redacció l'han de fer ells a casa seva,

at least. They have to do the writing at their home,

la poden fer de manera conjunta amb tu?

Can they do it jointly with you?

No, intentem que sigui a casa seva,

No, we try to make it at his/her home.

perquè pensem que és un moment

because we think it is a moment

no es pot fer ni en 10 minuts, ni en 15 minuts,

it can't be done in 10 minutes, nor in 15 minutes,

a consultar ràpidament.

to consult quickly.

Intentem que és un moment

Let's try that it's a moment.

que ho han de pensar, que ho han d'abordar,

that they have to think about it, that they have to address it,

que ho han de parlar amb els seus familiars

that they have to discuss it with their family members

si volen o no volen,

if they want or do not want,

i aleshores sempre els hi dono una segona visita.

And then I always give them a second visit.

No sé si es produeix

I don't know if it happens.

o s'ha produït alguna vegada

or it has never happened

algun conflicte familiar

some family conflict

de famílies que arriben

of families that arrive

i la mare, el pare, o qui estigui fent el document

and the mother, the father, or whoever is preparing the document

vol una cosa

He wants something.

i el familiar que acompanya

and the family member who accompanies

d'alguna manera no ho ha acabat de veure clar.

Somehow, he/she has not fully understood it.

Quan arriben a consulta

When they arrive for the appointment

jo crec que això ja està resolt.

I believe that this is already resolved.

Jo no m'he trobat mai,

I have never found myself,

però està clar que si la persona

but it is clear that if the person

està cognitivament bé

is cognitively fine

i farà el document de voluntats anticipades

And he will make the advance directives document.

sempre serà la voluntat de la persona.

It will always be the person's will.

No és el que digui el familiar.

It's not what the relative says.

Per molt que no vulgui o per molt que no estigui d'acord.

No matter how much I don't want to or how much I don't agree.

Aquest és l'avantatge, no?

This is the advantage, isn’t it?

I entenc que també és la incomoditat

I understand that it is also the discomfort.

de fer-ho prèviament, no?

to do it beforehand, right?

Que d'alguna manera manifestes allò

That you somehow express that

amb el que potser saps que no hi estarà d'acord

with what you may know he will not agree

tota la família, no?

the whole family, right?

Potser dius això, que no vols que

Maybe you say this, that you don't want to.

et mantinguin, per exemple,

they keep you, for example,

a través de màquines artificials

through artificial machines

en cas d'estar

in case of being

en una situació vegetativa, no?, per exemple.

in a vegetative state, right?, for example.

Hi ha una part que és opcional

There is a part that is optional.

en el document de voluntats anticipades

in the advance directives document

que és poder tenir un o dos representants.

What it is to have one or two representatives.

És opcional, o sigui, no és obligatori.

It is optional, that is, it is not mandatory.

Tu pots presentar el document de voluntats anticipades

You can submit the advance directives document.

sense representant, però sí que és veritat

without representing, but it is true

que pots tenir un o dos representants,

that you can have one or two representatives,

que aquests no hi ha problema perquè puguin ser família

that there is no problem for them to be family

o qui sigui, i que aquests

or whoever it may be, and that these

són les persones que, en el cas

they are the people who, in the case

que el metge, infermera o qui hagi

that the doctor, nurse, or whoever it may be

de fer aquest document

to make this document

tingui dubtes, anirien al representant

If you have doubts, they would go to the representative.

a preguntar-los. En teoria, jo sé

to ask them. In theory, I know

que sempre els dic que sigui una persona que et coneix,

that I always tell them to be a person who knows you,

que sap el que penses i...

that knows what you're thinking and...

En tot cas, entenc que el document ja deu tenir

In any case, I understand that the document must already exist.

algun tipus de format

some kind of format

perquè no hi capi gaire el dubte, no?

so that there is not too much doubt, right?

Exacte.

Exactly.

Entenc que aquesta situació hipotètica

I understand that this hypothetical situation

d'arribar a un cas, doncs,

if it comes to a case, then,

hi hagués algun professional sanitari que

there was some healthcare professional who

tingués dubtes, entenc que està redactat

I had doubts, I understand that it is written.

de tal manera perquè això no passi, no?

In such a way that this does not happen, right?

Sí, exacte, d'una manera molt minsa. I jo crec que també

Yes, exactly, in a very minimal way. And I think so too.

també dona peu a que

it also leads to the possibility that

doncs això, no?, hi ha dos germans que no estan d'acord,

so, that's it, right? there are two brothers who do not agree,

un sí i l'altre no.

one yes and the other no.

Qui és el representant? Doncs parlarem amb el representant.

Who is the representative? Well, we will talk to the representative.

Clar, clar. Clar, no sé,

Sure, sure. Sure, I don't know,

des de...

since...

Has dit, des que estic aquí jo,

You said, since I am here,

noto que cada vegada més la gent

I notice that more and more people

ho demana, no?, la gent n'és conscient

It asks for it, right? People are aware of it.

i no sé si també després

and I don't know if also afterwards

teniu dades o

do you have data or

sabeu de si això

do you know if this

està realment facilitant la vida

it is really making life easier

o facilitant situacions

or facilitating situations

que abans, doncs, potser eren

that before, well, maybe they were

més traumàtiques, no?,

more traumatic, isn't it?

o més difícils de...

or more difficult to...

Jo encara personalment no tinc

I still personally do not have.

el retorn de tots els documents que hem pogut fer

the return of all the documents we have been able to make

més que alguna persona que

more than someone who

després m'ho ha explicat, no? Sí.

Then he/she explained it to me, right? Yes.

Sí que és veritat que està facilitant

It is true that it is facilitating.

molt també, sobretot en els moments

very much so, especially in the moments

d'eutanàsia, o sigui, el poder demanar,

of euthanasia, that is, the power to request,

el poder fer la sol·licitud d'eutanàsia,

the ability to make the request for euthanasia,

que està clar que són casos minços i

that it is clear that they are minor cases and

molt puntuals.

very punctual.

Sí. Si tenen el document

Yes. If they have the document.

de voluntats anticipades anteriorment

of previously stated wills

fet és com un a més a més, no?

The fact is, it's like an addition, isn't it?

És a dir, és més fàcil, no?

That is to say, it is easier, right?

És més fàcil i és un pas

It's easier and it's a step.

més com perquè després

more like because after

puguin decidir el que fer.

they can decide what to do.

Que és una eina de decisió

What is a decision-making tool?

al final, de decisió, una decisió en aquest

in the end, a decision, a decision in this

cas pel final de la vida, que és

case for the end of life, which is

aquell moment en què no hi volem

that moment when we don't want to

arribar, però tots sabem que hi arribarem

arrive, but we all know that we will get there

abans o després. És una eina per poder

sooner or later. It is a tool to be able to

facilitar, per poder facilitar a tothom, eh?

to facilitate, in order to make it easier for everyone, right?

O sigui, a tothom, als familiars,

That is to say, to everyone, to the relatives,

a la persona, al personal sanitari.

to the person, to the healthcare staff.

Clar, jo no sé si també aquí es produeix com aquesta

Sure, I don't know if it also happens here like this.

cosa contradictòria que quan un va al CAP,

contradictory thing that when one goes to the health center,

no?, va com a

no? let's go like this

d'entrada, no?, va a curar-se.

At first, right? He/She is going to get better.

I això una mica és

And this is a bit what it is.

vaig a parlar de quan

I am going to talk about when.

em mori, no? I clar, no sé si això

I'm dying, right? And of course, I don't know if this

genera un punt de contradicció,

generates a point of contradiction,

no?, de dir, home, a veure, jo entro aquí

No? I mean, well, let's see, I'm coming in here.

no justament a parlar de la mort, no?

Not exactly talking about death, are we?

El que vull és parlar de viure, no?

What I want is to talk about living, right?

Clar, això és el que passa, no?

Sure, that's what happens, isn't it?

Això és la contradicció que a vegades es troba la gent

This is the contradiction that people sometimes find.

de que, bueno, jo vinc a fer això, però això no vol dir que

well, I come to do this, but that doesn't mean that

a mi a la primera canvi...

to me at the first change...

És a dir, a la gent li fa por, diu, a veure si hi posaré això

That is to say, people are scared, he says, let's see if I will put this in.

i de seguida desenduïaran

and soon they will come down

el que sigui, no? Bueno, doncs aquí està la meva

Whatever it is, right? Well, here is mine.

feina, no? Al final es tracta de baixar

Work, right? In the end, it's all about going down.

aquests nervis i de poder

these nerves and power

tranquil·litzar i dir que no és això. Sí que és

calm down and say that it is not this. Yes, it is

veritat que antigament... És a dir, t'atendran

Isn't it true that in the past... I mean, they will attend to you.

en un cas de parada cardíaca, t'atendran

in a case of cardiac arrest, you will be attended to

per intentar que tornis a respirar, eh?

to try to make you breathe again, huh?

Exacte. O sigui, sí

Exactly. So, yes.

que és veritat que antigament, i a més a més,

that it is true that in the past, and furthermore,

bueno, podíem parlar, no?, de l'esperança de

Well, we could talk, right?, about the hope of

vida. Abans l'esperança de vida era una, ara

life. Before, the life expectancy was one, now

l'esperança de vida és una altra. La medicina

Life expectancy is another thing. Medicine

ha avançat molt i pots mantenir

has advanced a lot and you can maintain

la persona viva molt de temps,

the person lived a long time,

però hem de mirar

but we have to look

amb quin... amb

with which... with

quina situació, en quin moment,

what situation, at what moment,

de quina manera, no? Al final és allargar

In what way, right? In the end, it's just prolonging.

la vida. Perquè sí

Life. Just because.

o allargar la qualitat de vida, no?

or extend the quality of life, right?

La qualitat de vida, que després, òbviament, el que dèiem,

The quality of life, which then, obviously, what we said,

al final això és un document de decisió

In the end, this is a decision document.

personal. Cadascú és lliure de decidir

personal. Everyone is free to decide.

allò que vulgui. Potser hi ha algú

Whatever you want. Maybe there's someone.

que vol que no el desenduïn

What do you want them not to descend?

mai en cap dels casos. Això, entenc, també

never in any of the cases. This, I understand, too

queda registrat, eh? Totalment. És a dir,

It gets registered, right? Totally. That is to say,

que aquí també, clar, heu de fer una feina

that here too, of course, you have to do a job

d'una manera absolutament objectiva,

in an absolutely objective way,

no? Imparcial. Exacte, absolutament imparcial,

no? Impartial. Exactly, absolutely impartial,

sense condicionar absolutament

without absolutely conditioning

res. Sí, sí. Simplement respondre els dubtes, no?

Yes, yes. Just answering the questions, right?

I a partir d'aquí... I no sé si això també es fa

And from here... I don't know if this is also done.

difícil o es pot fer difícil en cas...

difficult or it can be made difficult in case...

I no sé si hi ha sanitaris, també, que poden

And I don't know if there are health workers, too, who can

negar-se a participar en aquest

refuse to participate in this

procés, com per exemple amb el tema de l'eutanàsia, no?

process, like for example with the issue of euthanasia, right?

Exacte. En el tema de document de voluntats

Exactly. In the matter of the living will document.

anticipades, no. No hi ha aquesta possibilitat

anticipated, no. There is no such possibility.

de ser objectors de consciència que

of being conscientious objectors who

pot haver-hi en el tema de l'eutanàsia. Sí.

There may be on the topic of euthanasia. Yes.

També és veritat que és una altra manera diferent

It is also true that it is a different way.

de treballar i, al final,

to work and, in the end,

bueno, és la...

well, it is the...

decideixes la finalitat

you decide the purpose

de lo que diu la persona, però en

of what the person says, but in

final és una finalitat de vida. Al final és una finalitat

The end is a purpose of life. In the end, it is a purpose.

de vida. No poses un medicament per poder

of life. Don't put a medication to be able to

acabar amb la vida de la persona.

end the person's life.

És diferent. I, en principi,

It is different. And, in principle,

no. No hi ha objectiu de consciència en aquest

No. There is no objective awareness in this.

sentit. La gent, quan

felt. People, when

redacta aquest document, en aquells casos

draft this document, in those cases

en què no arribin perquè ja

in what they don't reach because already

tenen diagnosticada algun tipus de malaltia

they have been diagnosed with some type of illness

discapacitant o incurable

disabling or incurable

o el que sigui, no sé

or whatever, I don't know

si es posen en situacions hipotètiques

if they are put in hypothetical situations

o es planteja, és a dir,

or is posed, that is to say,

o es recomana això, perquè, clar, al final

or this is recommended, because, of course, in the end

has de fer com un exercici,

you have to do like an exercise,

no?, de... gairebé d'invenció,

no?, of... almost an invention,

no?, de... imagina't tu en una

No?, of... just imagine you in one.

situació final, no?, que

final situation, right?, that

ho tenim molt... és

we have it very much... it is

com molt cinematogràfic això, no?, gairebé.

How very cinematic this is, isn't it? Almost.

La part fàcil és quan la persona ve convençuda

The easy part is when the person comes convinced.

o ha passat una situació o...

either a situation has happened or...

aquesta és la part fàcil. La part més

this is the easy part. The more part

difícil i que ens costa a tots els sanitaris

difficult and that is hard for all of us healthcare workers

en general

in general

és, bueno, quan veus que a una persona

it's, well, when you see that a person

li han diagnosticat una malaltia, que segurament

they have diagnosed him with an illness, which will surely

pot ser degenerativa, que

it can be degenerative, that

el pronòstic pot ser fatal i que li has de

the prognosis can be fatal and that you have to

proposar tu poder fer aquest

propose you to be able to do this

document de voluntat anticipada. Ai, com es fa això?

advance directive document. Oh, how do you do this?

Ui!

Oh!

Això no és gens fàcil, s'ha de veure el moment,

This is not easy at all, it has to be seen in the moment,

s'ha de veure la situació.

The situation must be assessed.

Així tot, a vegades, si la persona està molt negada

Thus everything, sometimes, if the person is very stubborn.

s'ho pot prendre molt malament. Aleshores,

he might take it very badly. Then,

s'ha de tenir molt tacte

One must have a lot of tact.

i molta masquerra per...

and a lot of masquerade for...

perquè entenguin

so that they understand

que la realitat no és

that reality is not

que vagi pitjor,

I hope it goes worse.

o entenguin que no vols, no?

or they understand that you don't want to, right?

Hi ha persones que diuen, és que tu m'estàs dient

There are people who say, it's just that you are telling me

ja que moriré, que no sé què... Bueno,

since I'm going to die, I don’t know what... Well,

és ser una mica realista sense

It's being a little realistic without.

sense...

without...

Sí, sí, en situacions de vulnerabilitat, que si t'acaben

Yes, yes, in situations of vulnerability, that if they end up

de diagnosticar o t'han diagnosticat una malaltia,

to diagnose or you have been diagnosed with an illness,

doncs, òbviament estàs més

so, obviously you are more

vulnerable, això, no? Ara fredament

vulnerable, this, right? Now coldly

tots podem dir que tots morirem,

we can all say that we will all die,

però, clar, una cosa és dir-ho així

but, of course, one thing is to say it like this

i una altra cosa és veure-ho de front. Exacte.

And another thing is to see it head-on. Exactly.

Una altra cosa és que et donin un diagnòstic

Another thing is that they give you a diagnosis.

en què saps que, potser, això

in what you know that, perhaps, this

s'avança o va més ràpid del que un

is advancing or going faster than one

imaginava. De totes maneres,

I imagined. In any case,

sempre pots fer d'informar

you can always inform

i després la persona

and then the person

decideix, està clar. Però sí que és veritat

decide, it's clear. But it is indeed true.

que, a vegades, ja només el fet d'informar

that, sometimes, just the act of informing

fa que l'altra persona

makes the other person

es retingui enrere. Estem a la defensiva.

hold back. We are on the defensive.

És que vivim una mica, en la societat,

It's just that we live a bit, in society,

a la defensiva amb el tema de la mort.

defensive about the topic of death.

A mi, de morir no parlem.

Let's not talk about dying.

Es treu la conversa i dius, hem de parlar, i algú diu

You start the conversation and say, we need to talk, and someone says

hem de parlar d'aquests temes, que sembla

We need to talk about these topics, as it seems.

que estiguis parlant. No ens agrada això, Raquel.

That you are talking. We don't like this, Raquel.

No, per res. Hauríem de parlar amb més

No, not at all. We should talk more.

naturalitat? Hauríem.

Naturalness? We should.

Hauríem de parlar. I sí que és veritat que va millorant.

We should talk. And yes, it's true that it is improving.

O sigui, va millorant

So, it's getting better.

i cada vegada es parla més i cada vegada

And it is talked about more and more each time.

hi ha més malalties que et fan

there are more diseases that make you

parlar d'aquest tema, i tenim documents com aquest

talk about this topic, and we have documents like this

que ens ajuden a parlar d'aquest tema,

that help us talk about this topic,

però sí que és veritat que hi ha persones que no...

but it is true that there are people who do not...

Que no els agrada. Que t'hi posa barrera.

They don't like it. It puts a barrier between you.

I ja està. I també és

And that's it. And it is also

lícita i també s'ha de respectar.

legal and must also be respected.

Però, bueno, potser

But, well, maybe

penses, serà més difícil al final

you think it will be more difficult in the end

el procés. Sí, sí, sí.

the process. Yes, yes, yes.

Que al final es tracta, recordem,

That in the end, it's about, let's remember,

d'un document on bàsicament

of a document where basically

el que s'intenta és oferir una

what is attempted is to offer a

eina on la persona pugui

tool where the person can

decidir i deixar per escrit

decide and put it in writing

unes decisions que ha arribat

some decisions that has been reached

a un moment no hagi de prendre algú altre,

at a moment I shouldn’t have to take someone else,

traient també pes i responsabilitat així

also removing weight and responsibility this way

a familiars,

to relatives,

assegurant-se que, doncs això, moltes

ensuring that, therefore many

vegades, en la majoria de casos, com el que deies,

sometimes, in most cases, like what you said,

evitar un patiment que un pot considerar

avoiding a suffering that one might consider

innecessari o no, tant fa,

unnecessary or not, it doesn't matter,

és una decisió, el que dèiem,

it's a decision, what we were saying,

és una declaració personal,

it is a personal statement,

entenc que es pot modificar,

I understand that it can be modified.

és a dir... Sí, sempre es pot modificar

That is to say... Yes, it can always be modified.

o rebocar les vegades que facin falta. He canviat d'opinió,

or recoat as many times as necessary. I have changed my mind,

dius, pel que sigui,

you say, for whatever reason,

un té una decisió, després viu una experiència

one has a decision, then lives an experience

o veu el que sigui, diu, he canviat

or see whatever it is, he says, I have changed

d'opinió, no vull això. Es pot modificar o rebocar les vegades

of opinion, I don't want this. It can be modified or revoked as many times as needed.

que siguin necessàries. I el

that are necessary. And the

procés tarda molt de temps, és a dir, des que

the process takes a long time, that is to say, since

venen... Clar, el tracte és també d'un

They poison... Of course, the deal is also of one.

procés administratiu i amb una certa burocràcia,

administrative process and with a certain bureaucracy,

no sé, des del moment en què

I don't know, since the moment when

venen, et sol·liciten la informació i tu

they come, they request the information from you and you

facilites aquest document perquè se'n mirin

you provide this document so that they can look at it

a casa, no sé si és més o menys ràpid, això. Sí,

At home, I don't know if this is faster or slower. Yes,

és bastant ràpid, jo

I am quite fast.

sol tenir a la mateixa setmana

Only have in the same week.

cita i després es tracta que

quote and then it is about that

diguin quan ells creuen que

they say when they believe that

tindran el document per poder tenir la cita.

They will have the document to be able to have the appointment.

I ho demanen més dones o més homes?

Do more women or more men ask for it?

Més dones.

More women.

Sí, ja ho he pensat tal com

Yes, I have already thought about it that way.

m'ho has preguntat, però sí, més dones.

You asked me, but yes, more women.

I inclús més dones que diuen, el meu home

I even have more women who say, my man.

ha dit que ell no vol saber res, però

he said that he doesn't want to know anything, but

jo ho vull fer. Sí. Bueno, també

I want to do it. Yes. Well, also.

és un tema cultural que suposo que aniré canviant

It's a cultural topic that I suppose I'll be changing.

amb el temps, o això espero. Sí, sí.

with time, or so I hope. Yes, yes.

Bé, hi ha àrees

Well, there are areas.

en què les dones tenen com més iniciativa

in which women have more initiative

amb aquestes situacions.

with these situations.

Ho preguntava perquè tot el tema

I was asking because the whole topic

de les cures va molt

of the cares goes a lot

lligat a la dona, no? Al final la dona

tied to the woman, right? In the end, the woman

normalment és la que acaba... Exacte.

usually it's the one that ends... Exactly.

I potser és això, aquesta experiència

And perhaps it is this, this experience.

vital, no?, amb tot el món de les cures,

vital, right?, with the whole world of care,

no?, que moltes vegades són les dones les que s'acaben

No? That many times it is the women who end up.

cuidant doncs de les mares, de les àvies,

caring therefore for mothers, for grandmothers,

dels fills, de tot plegat, els que

of the children, of all this, those who

fan com percebre més a prop la realitat, no?

They make you perceive reality more closely, don't they?

Jo no vull que al meu fill li passi el que em va passar

I don't want my son to go through what happened to me.

a mi, jo no vull que

I don't want that.

la meva germana li passi el mateix que em va passar

my sister goes through the same thing that happened to me

a mi, sí. Doncs ja ho saben,

me, yes. Well, they already know it,

el document de voluntats anticipades,

the advance directives document,

el DBA, aquesta

the DBA, this

declaració per expressar les voluntats

declaration to express the wills

d'una persona sobre la salut, per si en un

of a person about health, just in case in a

futur, doncs pateix, per exemple, una malaltia

future, therefore suffers, for example, an illness

incapacitant o qualsevol situació

incapacitating or any situation

d'incapacitat que l'impedeixi

of incapacity that prevents him/her

fer-ho, pot deixar-ho per escrit

do it, you can leave it in writing

abans, ara ja, més fàcil,

before, now already, easier,

des de l'abril d'aquest passat, 2024,

since April of this past, 2024,

no calen tres testimonis, és una opció, eh?,

three witnesses are not necessary, it's an option, right?

si volen anar amb un familiar i trobar

if they want to go with a relative and find

dos testimonis, veïns, amics, qui sigui,

two witnesses, neighbors, friends, anyone,

que vagin, els acompanyin,

let them go, accompany them,

a fet, d'aquest document, és una manera.

In fact, this document is a way.

L'altre és anar amb un notari, un notari que potser

The other is to go with a notary, a notary who maybe

hi ha gent que ja ho fa així, però si no, hi ha

There are people who already do it this way, but if not, there is.

l'opció, des de l'abril, el que dèiem, que

the option, since April, what we said, that

simplement aquesta figura de testimoni

simply this figure of a witness

l'exerceixi el seu metge o la seva

the one exercised by his or her doctor

infermera de confiança, la del CAP,

trustworthy nurse, the one from the health center,

amb qui vostès es visiten habitualment

who do you usually visit with

i, per tant, no hagin de fer passar

and, therefore, should not have to go through

per aquest tràngol moment,

for this difficult moment,

situació, doncs cap familiar,

situation, so no family,

ni cap amic, ni cap altra

neither any friend, nor any other

persona del seu cercle.

person in their circle.

Si volen, també saben que

If they want, they also know that

poden demanar o

they can request or

fer-se acompanyar per dos

to be accompanied by two

representants, no?, ho ja has explicat, Raquel,

representatives, right? You've already explained it, Raquel,

això ja és una cosa opcional,

this is already an optional thing,

és un tema prou ràpid i,

it's a fairly quick topic and,

d'alguna manera,

somehow,

treu pes en aquest moment

take weight off at this moment

de final de la vida, que és difícil, doncs

of the end of life, which is difficult, then

treu pes a les decisions en situacions

takes weight off decisions in situations

amb molta vulnerabilitat, en les que

with a lot of vulnerability, in which

no ens hi volem veure mai

we never want to see it again

i, tant de bo, no hi ens haguem de veure,

I wish we didn't have to see each other there.

però sabem que passen.

but we know they happen.

Raquel, un plaer, com sempre,

Raquel, a pleasure as always.

moltes gràcies, que vagi molt bé.

thank you very much, have a great time.

Adéu.

Goodbye.