Advance care planning helps you think about your future health, care and treatment wishes. It gives you the opportunity to talk about what matters most to you, the care you would want, and any treatments you may not want in the future.
Planning ahead for your care is voluntary. It can help your family, carers and healthcare professionals understand your wishes if there comes a time when you are unable to speak for yourself.
Why thinking ahead matters
Serious illness and ageing can bring difficult decisions. Many people worry about losing control over choices about their future care and treatment.
If there comes a time when you cannot make decisions or communicate your wishes, planning ahead helps ensure that the people caring for you understand what is important to you. This can help make sure your preferences and choices are taken into account.
What is advance care planning?
Advance care planning is a voluntary conversation about your future care and treatment. These discussions usually take place between you and the professionals involved in your care. It can also include the people who are important to you, such as relatives, carers or close friends.
These discussions may take place:
- when you are diagnosed with a life-limiting condition
- when your condition begins to get worse
- when you are in good health but want to think about future care decisions
Healthcare professionals may use a document such as a PEACE document or a ReSPECT document to record these discussions in a structured way.
What can be included in a care plan?
Planning for your future care can cover a range of decisions, wishes and preferences. The discussion will depend on your individual circumstances.
This may include:
- how common problems related to your condition may be managed, such as infections, falls or breathlessness
- where you would prefer these issues to be managed
- decisions about cardio-pulmonary resuscitation (CPR)
- treatments you may wish to have
- treatments you would prefer not to have
These conversations can also include information about what matters most to you, such as:
- what is important in your day-to-day life
- where you would prefer to be cared for if you become more unwell
- who is involved in your care, such as relatives or carers
- your values and beliefs
- your priorities for quality of life, such as spending time with family
- what is important to you at the end of your life
- your funeral plans and wishes
You do not have to decide everything at once. Planning ahead can happen over time and should take place at a pace that feels right for you.
Once your wishes and preferences have been discussed, they should be recorded so that professionals involved in your care are aware of them.
Where are plans recorded?
Advance care plans are recorded on the Electronic Palliative Care Coordination System (EPaCCS). In mid and south Essex, this is held within a secure clinical system called SystmOne, which is used by a number of health and care services.
Having a shared record means that the professionals involved in your care can see your wishes, priorities and needs more easily. This supports better coordinated care and can help teams respond more effectively if your needs or circumstances change.
Only professionals involved in your care can access this information through your usual care records. This helps ensure the people looking after you understand your conditions, care needs and personal wishes.
Are plans legally binding?
Advance care planning is voluntary and is not usually legally binding. However, it helps professionals understand your wishes and preferences, especially if you are unable to communicate them yourself.
Advance care planning can help make sure your care reflects what matters most to you, including towards the end of life.
Can I change my mind?
Yes. You can change your mind about your wishes and preferences at any time.
Your advance care planning discussion should be reviewed regularly with the people close to you and your healthcare team, so it continues to reflect your wishes.
What should I do next?
If you are interested in advance care planning, speak to your GP, hospital team or another healthcare professional involved in your care.
They can help you start a conversation about advance care planning and explain any related documents that may be helpful for your situation.
Lasting power of attorney
A lasting power of attorney (LPA) is a legal document that allows you to appoint one or more people to make decisions on your behalf.
An LPA must be registered with the Office of the Public Guardian before it can be used. Registration must happen while you still have the mental capacity to make that decision.
There are two types of lasting power of attorney.
Property and financial affairs
This covers decisions about money and property. You can choose whether this takes effect as soon as it is registered or only if you lose mental capacity.
Health and welfare
This covers decisions about personal welfare and healthcare, including medical treatment. It only takes effect if you lose the mental capacity to make decisions for yourself.