Advance care planning

What is advance care planning?

Advance care planning is the process of discussing your preferences and wishes about future treatment and care with those close to you and your healthcare team. This may include:

• talking about where you want to be cared for
• identifying the people you’d like to be consulted about your care
• making decisions about medical treatment in advance

Advance care planning helps health and care professionals, and those close to you, to understand how you want to be cared for if you become too ill to make decisions or speak for yourself. You can also formally document your wishes as part of this process in an advance care plan.

When does advance care planning happen?

Advance care planning generally happens if someone has a serious illness, but you can plan ahead for your future treatment and care at any time in your life.

If you’ve been diagnosed with a serious illness then someone involved in your care, such as such as your doctor or nurse, might start a conversation with you about advance care planning. However, you do not have to wait for someone else to talk to you about your wishes. You can ask your doctor or nurse about it at any time.

Advance care planning is a voluntary process, so you do not have to take any steps to plan in advance unless you wish to do so. However, talking about and recording your wishes in advance will mean that they are more likely to be known by others and followed if you are unable to make decisions for yourself.

What is involved in advance care planning?

There is no set way to plan in advance, but there are several things you can do to ensure people know how you’d like to be cared for. These include:

• Discuss what you want with those close to you and your healthcare team. You can use this discussion to explain your wishes and preferences for care. If you want to, you can also talk about what you’d like to happen after your death, for example, if you’d like to donate your organs. It’s a good idea to make a note of these wishes and let other relevant people know.
• Explore your options about where you would want to be cared for, such as at home or in a hospice.
• Refuse specific treatments in a living will (advance decision) in case you become unable to make decisions for yourself in the future.
• Write down your wishes, preferences, feelings and beliefs in an advance statement. This allows you to document anything that’s important to you in relation to your future treatment and care.
• Appoint a health power of attorney to give someone you trust the power to make decisions for you.

Is an ACP legally binding?

An advance care plan isn’t legally binding. However, if you’re near the end of life it’s a good idea to make one so that people involved in your care know what’s important to you. Your healthcare team will try to follow your wishes and must take the document into account when deciding what’s in your best interests.

What should I include in my Advance Care Plan?

You should include anything that’s important to you in relation to your future health and care. The kind of wishes you can set out include:

• where you want to be cared for and where you want to die (these could be the same place or different places)
• who you want to be with you near the end of life
• values such as religious belief
• any dietary requirements you have

Talking to people about your wishes

It’s a good idea to talk to your doctor or nurse about your wishes and preferences. They’ll be able to explain your treatment and care options and help you to understand how any decisions or choices you make will affect you. They can also discuss whether or not your wishes are realistic. For example, if you’d prefer to die at home but do not have anyone close who can support you at home, it may be better for you to be cared for in a hospice.

It can be difficult to talk to the people close to you about your wishes and preferences for the end of life. Sometimes they may not want to acknowledge that you’re dying or they may disagree with you. However, if you feel able to, it’s important to involve those close to you when you fill in the document because it can help them to understand what you want, what’s likely to happen to you, and to be realistic about what is possible.

You can find more helpful tips about talking to your doctor and those close to you about your wishes for treatment and care in our Starting the Conversation guide.