Advance care planning

Thinking about future care and planning ahead can feel very difficult, but it can also help you feel more in control and ensure your wishes are understood and respected. Taking steps to plan ahead can provide reassurance for you and those close to you.

This leaflet developed by our Palliative Care Team provides further information and guidance.

This section provides information about services and support available to help you plan for the future, including community palliative care, lasting power of attorney (LPA), and will writing. It explains what these services involve and how to access them if and when you feel ready.

Our aim is to support you in making informed decisions about your care and personal arrangements, at a pace that feels right for you.

What is advance care planning (ACP)

Advance care planning is a voluntary process which gives you the opportunity to establish what plans you want to make for your future care, often in discussion with a healthcare professional. Whatever stage you are at in life, it can be helpful to plan for the future. If you were to become very unwell and unable to make decisions for yourself it is useful for anyone making decisions for you, to understand what is important to you and what your wishes are.

Your wishes may change or evolve overnight, ACP is a flexible process so details can be reviewed on a regular basis and any changes made when necessary.

What type of things are included in ACP?

• What makes you “you”, personal goals, wishes and discussion around where you would want to be cared for if you were less well
• Decisions that may need to be made about your care in the future such as medial treatments, including discussions around cardio-pulmonary resuscitation (CPR), admissions to intensive care, continued treatment of infection and giving foods/fluids via a tube or drip if you cannot eat and drink for yourself
• Advanced decision to refuse treatment – legally binding document to highlight any treatments or interventions you might want to refuse
• Establishing a Lasting Power of Attorney
• Writing a Will
• Corneal, tissue and organ donation

Resources

Macmillan guidance on advance care planning and planning ahead

Marie Curie information about planning ahead

Universal Care Plan (UCP)

In London we use the UCP to record your ACP wishes, this is an electronic record that can be accessed by emergency services, GP practices, community services and hospital clinicians. UCP is a digital based care plan based on what matters to you.

With your consent, a care plan can be created following a conversation between you and your healthcare professional (such as a doctor or nurse). This is an evolving process and can be updated at any point if your wishes change. You can view your care plan in your NHS app.

Universal Care Plan information

Writing a will

A will is a legal document that details your wishes for who you would like to give your money and belongings to when you die. Macmillan have a guide to explain what this process involves.

Step by step guide to writing a will

Marie Curie have a free will writing service

 Lasting power of attorney (LPA)

Choosing someone to be your lasting power of attorney enables that named person to be able to make decisions on your behalf. You can find out more information and apply to appoint someone as your LPA here

Advance decision to refuse treatment (ADRT) a living will

An advance decision (sometimes known as an advance decision to refuse treatment, an ADRT, or a living will) is a decision you can make now to refuse a specific type of treatment at some time in the future.

It lets your family, carers and health professionals know your wishes about refusing treatment if you’re unable to make or communicate those decisions yourself.

The treatments you’re deciding to refuse must all be named in the advance decision.

You may want to refuse a treatment in some situations, but not others. If this is the case, you need to be clear about all the circumstances in which you want to refuse this treatment.

Further information from the NHS can be found here

Organ donation

If you have active cancer, it is unlikely you can donate organs, but you are still usually able to donate tissue.

Further information can be found on the NHS organ donation website

Further information about tissue and corneal donation can be found here

Caring and planning for your pets

The Cinnamon Trust is the only specialist national charity for people in their last years and their much loved, much needed companion animals.

RSPCA will rehabilitate them wherever possible, provide them with the very best veterinary care and to find them new homes, either through rehoming or release

Spirituality

Spirituality can be an important part of your values and beliefs. Considering it in advance care planning ensures that your care reflects what matters most to you. Further information about the chaplaincy and spiritual care team at St George’s can be found here Chaplaincy & Spiritual Care – St George’s University Hospitals NHS Foundation Trust