This sheet answers common questions about advance care planning (ACP). If you would like further information, or have any concerns, please do not hesitate to ask your nurse or doctor.
What is ACP?
ACP is a voluntary process to help you consider what you might want, or not want, for your future care and treatment through discussions with your care providers and those important to you.
Why is this relevant to me?
None of us can predict the future. Our health can deteriorate over time or can be suddenly affected by an emergency. Therefore, it is important to think in advance about what would happen if you became too unwell to make or communicate decisions for yourself.
Every adult should have the opportunity to discuss their wishes and priorities for the future. Although ACP has traditionally been associated with life-limiting illnesses, it’s a process that can support a better quality of life for adults at any stage in life, including those who are fit and well.
How does it work?
Your wishes and priorities for your care are documented and recorded in an advance care plan, which can be shared with healthcare professionals in your community and hospitals. Although specific treatments cannot be requested in your plan, healthcare professionals will consider your wishes and recommendations when providing care, support, and treatments.
At the Royal Free London, a secure electronic system called Universal Care Plan is used to record and share your advance care plan with healthcare professionals. Those involved in your care will be able to view your advance care plan, including your GP, ambulance service, community matrons, and hospital clinicians. We will always ask for your consent before documenting your plan on Universal Care Plan.
What sort of things might I plan for?
Your priorities will be influenced by your health conditions and circumstances and will likely differ to others’. Your doctor can talk you through what to include in your advance care plan, including what is most applicable to you and your situation. Questions that some people consider when thinking about their future wishes for care and treatment include:
- If I can no longer speak for myself, who would I like to be my spokesperson?
- Where and how would I prefer to be cared for now and in the future?
- What spiritual needs do I have now and in the future?
How might I benefit from an advance care plan?
There are several benefits to creating an advance care plan:
- You can expect to receive care which considers what matters to you.
- It can be an opportunity to talk about your specific health needs now and plan for future needs.
- It will ensure your plan is considered when making treatment decisions, particularly in the event of an emergency or if you become too unwell to make or communicate decisions for yourself.
How do I make an advance care plan?
Talk to your friends and family about your preferences, wishes and priorities for your care in the future. It may also be helpful to speak with your GP or other healthcare professional who can discuss your thoughts and feelings with you. Your GP or healthcare professional can then help you put your advanced care plan together and enter your plan onto a secure electronic system.
There are several ways in which you can ensure your wishes are taken into consideration:
This is an easy and informal way of expressing your views in a written document which forms the basis for an advance care plan. You can include any information which you think would be helpful for those who care for you to know. This is not a legal document - while your doctors will use this to guide them in making decisions regarding your care, they are not legally bound by this document.
You may have strong views regarding treatment that you would not wish to have in certain circumstances. The ADRT is a legal document which allows you to make it clear which treatments you would not want in the future. If you have made an ADRT, doctors have a legal obligation to follow its instructions if you are unable to express your views.
When making your ADRT, it’s best to discuss this with your doctor as the instructions need to be specific. You cannot use this document to request treatment. The document must be signed and witnessed.
You may choose to appoint somebody to make decisions on your behalf if you are no longer able to make them for yourself. An LPA can be appointed for health and welfare and/or financial decisions. Most people would choose to appoint a close family member or friend who is familiar with their views on their care and medical treatment.