Advance Care Planning
Advance Care Planning (ACP) is for everyone – individuals, families and carers. It is a voluntary process that helps you think about, talk about, and record your wishes for future care. It also helps your family, carers and health professionals understand what matters most to you if you become unwell and are unable to speak for yourself. ACP is about planning ahead so that care can reflect your values, preferences and priorities – wherever you are cared for.
If someone doesn’t have the mental capacity to carry out advance care planning, then discussion with their family, Lasting Power of Attorney for Health and Welfare (LPA), GP, nurse or social worker can help determine what would be in your ‘Best Interests’. Best Interest Meetings are formal gatherings designed to support decision-making on behalf of individuals who lack the capacity to make decisions themselves.
These meetings are governed by the principles outlined in the Mental Capacity Act, which emphasise the importance of acting in the individual’s best interests, considering their past and present wishes, feelings, beliefs, and values.
A best interest meeting may also include an independent Mental Capacity Advocate (IMCA) where there is no one independent of services, such as a family member or friend, who is able to represent the person.
Introduction
Advance Care Planning is a way to think ahead, to describe what matters to you and to ensure that other people know your wishes for the future. It’s about helping you to live well, right to the end of your life.
Thinking ahead, discussing with others and writing things down means that your wishes are known and respected. So if you become unwell, or can no longer speak for yourself, you are more likely to receive the kind of care you want in a place you choose.
Advance Care Planning is a very simple process. It is just five simple steps.
The Advance Care Planning Process can be covered in 5 simple steps.
Step 1 - Think
Think about the future:
- What matters to you?
- What would you want to happen or not want to happen if you become unwell?
- Who would speak for you if you couldn’t speak for yourself?
Step 2 - Talk
Talk with your family and friends. Make sure they are aware of your choices and ask someone you trust to speak on your behalf if you are unable to speak for yourself. This is known as a Lasting Power of Attorney (LPA) for Health and Welfare (LPA).
Step 3 - Record
Write down your thoughts or ask someone to help you record your wishes as your own Advance Care Plan. There are different ways of doing this. You could use your local GP’s form, the GSF Thinking Ahead tool or another Advance Care Planning document. Or you could complete it online as part of your digital legacy plan. Whatever method you choose, make sure those that care for you know about it and can find it when needed, including your Lasting Power of Attorney for Health and Welfare (LPA).
Step 4 – Discuss
Discuss your plan with those that look after you. This could be your doctor, nurse or your care provider.
Tell them what matters to you, where you prefer to be cared for and the kind of things you would like to happen to you. This is known as an Advance Statement.
You may want to discuss what you don’t want to happen, known as an Advance Decision to Refuse Treatment or ADRT.
You may also want to tell them who your chosen Lasting Power of Attorney for Health and Welfare (LPA) is, so they know who would speak for you if you couldn’t speak for yourself.
The doctor or nurse may discuss with you what to do in an emergency. They may have completed a ReSPECT form or an Emergency Health Care Plan with you. The doctor or nurse may also want to discuss what to do if your heart suddenly stops. This is a Resuscitation or DNACPR discussion.
Step 5 - Share
Share this information with family or friends involved in your care and let them know where your documents are kept. Your healthcare team will make sure they are shared with others involved in your care.
Review
As time passes, your situation can change, so it is important to review your Advance Care Plan regularly. If you need to update it, it’s best to discuss it with your doctor, your nurse or your care team and inform your family, next of kin or Lasting Power of Attorney for Health and Welfare (LPA).
ou can do advance care planning at any time but it is especially important towards the end of life. It will help you get the care you really want and live the life you want to lead.
Just remember the Five Simple Steps – Think, Talk, Record, Discuss, Share.
Advance Care Planning Resources
View GSF accredited organisations in your area, who can help you and your family plan ahead and ensure care reflects what matters most.