ADVANCE PLANNING
By taking responsibility for what we want and don't want at the end of life is in itself empowering. Once we have stated our wishes we can get on with living life to the full.
JAMIE 48 - EXAMPLE PLAN 1
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Jamie is fit and physically active. He is responsible for managing a team of health practitioners. Because of his work Jamie has first hand experience of the benefits of having a plan. He runs most days and likes to go exploring on his motor bike. He is divorced with two grown-up daughters . He did an Advanced Plan soon after his 48th birthday.
TO HELP YOU DECIDE WHAT TO PUT IN YOUR ADVANCE PLAN, CHOOSE AN EXAMPLE TO USE AS A TEMPLATE.
Why plan? And When?
Death is universal and inevitable; we just don’t know when it will happen. It could be as a result of old age, a terminal illness, a stroke, an accident or an injury. Whilst we cannot control the time and cause of our death we can influence where and how we are cared for. If you have a written plan for how you want your dying and death to be it is more likely to happen.
There may come a time when you are unwell and cannot tell the people around you what you do and do not want. By making plans now, you can record your preferences for treatment and care so that if you are ever in this situation, your wishes are known and can be followed. We believe this can be done at any stage of life so there is more likelihood that your preferences will be respected and you can relieve those you love of having to make difficult decisions on your behalf.
MARTHA 52 - EXAMPLE PLAN 2
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Martha has angina which is controlled by medication. It doesn't limit her activities too much but it has made her think about her future more deeply. Recently she wrote her Advanced Plan which took a couple of hours. She felt some anxiety lift once she had completed it.
What to Cover in the Plan
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What does quality of life mean for you
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How you want to be cared for, by whom and where
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Your wishes, preferences, values, beliefs and personal goals
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The things that are important in your life
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Activities you enjoy
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The things that are important to your identity
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Your likes and dislikes
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The important people in your life
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Medical treatments that you do not want to be given in the future
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Who do you want to speak for you if you can’t speak for yourself
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Your views on organ donation
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What to do about your online presence – social media, accounts
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Your affairs – where important papers are kept – Will, Lasting Power of Attorney, Pension information and so on
SAM 65 - EXAMPLE PLAN 3
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Sam had a double mastectomy and complete node removal on her left-hand side. She felt her energy had dropped and that her general mobility had decreased in the last six months. She completed her Advance Plan after a discussion with her husband.
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Put some time aside to think about and write down your thoughts under the areas we have given in WHAT TO COVER IN YOUR PLAN
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Have a conversation with a close friend or family member and then write down your conclusions
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Do it online (you can print off the forms too) https://compassionindying.org.uk/library/
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Talk to an End of Life Doula who will support you to prepare your plan https://eol-doula.uk/contact-us/
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https://www.ageuk.org.uk/information-advice/money-legal/legal-issues/advance-decisions/
How Do I get Started
MAX 71 - EXAMPLE PLAN 4
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Max has recently found he has been forgetting things which is not in his nature and so he believes he might have the onset of dementia. While this has been a big concern for Max, he felt a sense of relief when he completed his Advance Plan
What I Do & Don't Want
An Advance Decision allows you to record any medical treatments that you do not want to be given in the future in case you later lack capacity and cannot make or communicate a decision for yourself. These treatments may be life-prolonging at the expense of quality of life. The legal name is an Advance Decision to Refuse Treatment, and it is sometimes called a Living Will or an Advance Directive. If an Advance Decision meets certain simple requirements it is legally binding. Your Advance Decision will only be used if you lack capacity to make a decision.
An Advance Statement allows you to make general statements describing your wishes and preferences about future care should you be unable to make or communicate a decision or express your preferences at the time. You may want it to reflect religious or other beliefs and important aspects of your life. You can include things such as food and drink preferences, type of clothes you like to wear, music, TV or DVD preferences, or whether you like a bath or a shower etc. You can say who you would like to visit you or be consulted about your care.
Simple Explanations
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Lasting Power of Attorney (LPA)
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This is a legal document that lets you appoint someone to help you make decisions or make decisions on your behalf should you ever lack capacity. You can register with the Office of the Public Guardian
https://www.gov.uk/government/publications/make-a-lasting-power-of-attorney
There are two separate forms - Health & Welfare LPA and Financial LPA. The cost for both is £164
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Digital Legacy
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As much of our banking, photos, videos, data and files are online, it is worth planning for your digital legacy. This can be done by leaving specific instructions in a Will or appointing a Digital Executor.
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Wills
Over half of Adults in the UK do not have a will. You can draw up your own will if your affairs are straightforward. You can get excellent advice from https://www.citizensadvice.org.uk/family/death-and-wills/wills/
But you might want to go to a solicitor to discuss the matter or get them to check over your documents.
Advance Decision to Refuse Treatment
An advance decision to refuse treatment also known as an advance decision, 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 should you lose mental capacity e.g. severe dementia, a stroke etc. Examples of treatments that can be refused include, but are not limited to Cardiopulmonary Resuscitation, Mechanical or Artificial Ventilation, Artificial Nutrition and Hydration and Antibiotics. It is legally binding and to be valid must be made when the person has mental capacity and be signed, dated and witnessed. It must include the words I maintain this refusal even if my life is at risk or shortened as a result.
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Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)
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A Do Not Attempt Cardio Pulmonary Resuscitation form is a document issued and signed by a doctor, which tells your medical team not to attempt cardiopulmonary resuscitation (CPR). It’s not a legally binding document. Instead, it helps you to communicate to the healthcare professionals involved in your care that CPR shouldn’t be attempted. If you decide to have one, it’s a good idea also to make this a refusal in your advance decision. This will mean that your wishes are more likely to be followed if you lack capacity to make decisions.