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Advance Care Planning

This leaflet explains how to consider your choices and preferences for the future – if you have any other questions, we hope you will talk them over with a member of staff who will be glad to help.

1 Why does thinking ahead matter to me?

Serious illness and ageing bring challenges that many of us prefer to avoid thinking about. At the same time many of us fear loss of control about decisions relating to our health care.

Thinking ahead and writing down what matters to you can be a daunting process. However if no one else knows what is important to you, your preferences and choices may not be taken into
consideration. It may be difficult to talk together as a family and you may not always agree, but having these conversations can help direct decisions that sometimes need to be made at a time of crisis. You may like to talk to someone in your health care team also.

Writing your preferences down will ensure that anyone who provides care for you, carers or health professionals can tailor it to your wishes.

2 What is advance care planning (ACP)?

ACP is the process of deciding what plans you want to make for your future care, often in discussion with a healthcare professional. This may take place when a person’s condition begins to deteriorate but can happen whenever a person is thinking about what care they might need in the future.

3 Why is it a good idea to write down what I think?

Writing down your preferences and choices can help you to influence what happens to you if a time comes when you are no longer able to care for yourself. It gives you the opportunity to think about what you would and would not like to happen to you.

It will also help healthcare professionals know what is important to you when planning your care should you ever not be in a position to tell them yourself.

4 Where can I write down my preferences?

There is a booklet you can use for this purpose. The booklet will guide you through a series of questions and ideas for you to think about. The booklet is yours and you can show it to whoever you decide needs to see it. Just ask your nurse if you would like one.

5 What sort of things should I write about?

Advance care planning should incorporate everything that is important to you, for example your physical care or your values and beliefs. Bearing in mind your circumstances can change, the booklet can help you to think about aspects of care that you haven’t yet had to consider. You do not have to complete it all at once, you may want to think about or discuss things with your family and/or friends or your healthcare team.

6 Can I change my mind once I have written down my wishes?

Recording your preferences in this way creates an ‘advance statement’ which is not legally binding. You should review it regularly with your family or health care team and you can change your mind at any time.

7 What about treatment and care I do and don’t want?

Sometimes it can be helpful to talk about issues that might arise as a result of your illness. These could be around discussing where you might prefer to be cared for if you were to become less well, as well as thinking about what your priorities are in relation to maximising the quality of your life. Whilst also making decisions around care and treatment you might want, against those you would prefer not to have.

An Advance Directive to Refuse Treatment (ADRT) is a legally binding document. If there are any treatments or procedures that you do not want you will need to discuss this with your doctor. It is
important that an ADRT is put in writing, signed and witnessed and that it includes a statement that the decision stands ‘even if life is at risk’.

8 Who can I talk to if I want further help about anything in this leaflet?

Any members of the St Christopher’s Clinical Team will be pleased to talk with you about anything relating to ACP. You can contact them by telephoning 020 8768 4500. Or, if you prefer, you can speak to your own GP or district nurse.