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Advance care planning

Many people are concerned about how decisions about their medical treatment would be made if they lost the ability to decide themselves. Some people wish to think about future health care options in advance, some people do not.

Advance care planning is a dynamic process of discussions between you, those close to you and professionals providing care for you. During these discussions you may wish to express your views, preferences and wishes about your future care.

Advance care planning may take place at any time you feel is right for you. The process is entirely voluntary. The aim is to identify your wishes and preferences and ensure that people are aware of them. It is also possible to refuse a specific treatment. Some of the issues that are included in the advance care planning discussions are listed below.

Identifying wishes and preferences

You may have strong views about treatments or types of care you may be offered. Where you would be cared for might be important for you. For example you may wish to receive all care at home even if you become very unwell.

You may have spiritual or religious beliefs that you wish to be taken into account in your care. There may be practical things that are very important for you, for example you may prefer a shower to a bath. Or you may have concerns such as who would take care of your pets if you become unable to do so yourself.

You might wish to identify someone close to you to represent your views. This is different from Lasting Power of Attorney, as it is not legally binding, but the health and social care professionals are expected to take your views into account when planning your care. Sometimes it may not be realistic or practicable to follow your wishes.

It is not necessary to have your wishes and preferences written down, but it might be useful for those involved in your care if your views are in writing.

Refusing specific treatment

An advance decision to refuse treatment (previously known as a living will or advance directive) is a decision you can make to refuse a specific type of treatment at some point in the future. You may wish to refuse a treatment in some specific situations but not in others. It is important to specify the details of the circumstances.

There are specific rules if you wish to refuse a life sustaining treatment, such as ventilation. A decision to refuse treatment must be put in writing, signed and witnessed. If you wish to refuse a treatment you are advised to discuss this with an experienced care professional who knows your medical history well.