Why do advance care planning

Knowing what matters most and sharing your wishes can help you feel supported in your decisions. Having conversations with your healthcare team and those closest to you will help them understand what's important to you.

You can write your wishes in a document called an advance care plan, advance statement or, in Scotland, an anticipatory care plan. Writing down your wishes can make it easier for people to understand and follow them in the future. Your doctors or nurses can help you understand what sort of care you might need in the future, so you know what decisions to include.

It's your choice whether you make an advance care plan. You shouldn't feel pressure to include anything you're not comfortable with. Your doctor or nurse might suggest that you have a conversation about your future care. But you can begin the conversation with them at any time. Ask your healthcare professional for an advance care planning form. You could also try:. Once you've decided what to have in your plan, give a copy to the people involved in your care and your family or friends.

Your doctor or nurse can tell you how to make sure other health and social care professionals know about your advance care plan. They might be able to create an electronic record of your plan that could be accessed by hospital staff or out-of-hours doctors. These services vary depending on where you live. If you have a carer or someone who looks after you, give them a copy or tell them where you keep your advance care plan. It's a good idea to review your plan regularly to make sure it still reflects your needs and wishes.

If you need emergency care when your GP practice is closed, for example overnight or at the weekend, it's useful for other professionals to know about you. Digital records can be shared between your GP and professionals who provide care out of hours. Knowing about you, your medical condition, your medications, and your wishes means they can give you the best care for you. You can ask your GP to include information about your advance care plan in your digital healthcare record.

An advance decision to refuse treatment ADRT is a written decision to refuse a specific type of medical treatment. It's sometimes called an advance decision or living will. In Scotland, it's called an advance directive. An ADRT can be part of your advance care plan but you need to write it in a certain way. If it's written and signed in the correct way, your doctors and nurses must follow it. An ADRT will only be used if you lose the ability to make your own decisions about your treatment.

Your doctor or nurse has to follow your ADRT as long as it's valid and applies to your current situation. In Scotland and Northern Ireland, there isn't an act of law but it's likely to be considered legally binding by a court. You need to share your ADRT with your health and social care professionals so that they know what treatments you don't want to receive. Cardiopulmonary resuscitation CPR is a treatment that aims to start breathing and blood flow in people who have stopped breathing or whose heart has stopped beating.

Some people decide that they don't want to have CPR. CPR isn't beneficial for everyone and can cause serious complications. Ask your doctor or healthcare team to explain what these might include. It can help you think about who you would want to make decisions for you if you can't make them yourself. It will also discuss ways you can share your wishes with others.

Knowing who you want to make decisions on your behalf and how you would decide might take some of the burden off family and friends. Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know—both your family and your health care providers—about your preferences. These preferences are often put into an advance directive , a legal document that goes into effect only if you are incapacitated and unable to speak for yourself.

This could be the result of disease or severe injury—no matter how old you are. It helps others know what type of medical care you want. An advance directive also allows you to express your values and desires related to end-of-life care.

You might think of it as a living document—one that you can adjust as your situation changes because of new information or a change in your health. Sometimes decisions must be made about the use of emergency treatments to keep you alive.

Doctors can use several artificial or mechanical ways to try to do this. Decisions that might come up at this time relate to:. What is CPR? Cardiopulmonary resuscitation might restore your heartbeat if your heart stops or is in a life-threatening abnormal rhythm. It involves repeatedly pushing on the chest with force, while putting air into the lungs.

This force has to be quite strong, and sometimes ribs are broken or a lung collapses. Electric shocks, known as defibrillation, and medicines might also be used as part of the process. The heart of a young, otherwise healthy person might resume beating normally after CPR. Often, CPR does not succeed in older adults who have multiple chronic illnesses or who are already frail. Using a ventilator as emergency treatment. Ventilators are machines that help you breathe.

A tube connected to the ventilator is put through the throat into the trachea windpipe so the machine can force air into the lungs. Putting the tube down the throat is called intubation. Because the tube is uncomfortable, medicines are often used to keep you sedated while on a ventilator. If you are expected to remain on a ventilator for a long time, a doctor may perform a tracheotomy or "trach" rhymes with "make".

During this bedside surgery, the tube is inserted directly into the trachea through a hole in the neck. For long-term help with breathing, a trach is more comfortable, and sedation is not needed. People using such a breathing tube are not able to speak without special help because exhaled air does not go past their vocal cords. Using artificial nutrition and hydration near the end of life. If you are not able to eat, you may be fed through a feeding tube that is threaded through the nose down to your stomach.

If tube feeding is still needed for an extended period, a feeding tube may be surgically inserted directly into your stomach. Hand feeding sometimes called assisted oral feeding is an alternative to tube feeding.

This approach may have fewer risks, especially for people with dementia. If you are not able to drink, you may be provided with IV fluids. These are delivered through a thin plastic tube inserted into a vein. Artificial nutrition and hydration can be helpful if you are recovering from an illness. However, studies have shown that artificial nutrition toward the end of life does not meaningfully prolong life.

Artificial nutrition and hydration may also be harmful if the dying body cannot use the nutrition properly. What is comfort care at the end of life?

Comfort care is anything that can be done to soothe you and relieve suffering while staying in line with your wishes. Comfort care includes managing shortness of breath; limiting medical testing; providing spiritual and emotional counseling; and giving medication for pain , anxiety, nausea, or constipation. Advance Care Planning is a process of planning for future health. It involves thinking about the questions above and other matters that are important to you.

It involves finding the right time to do that — ideally not in at a time of crisis. It should take place at a time that works best for you. In talking about advance care planning process this site says:. Advance care planning can involve thinking about lifestyle decisions as well as decisions about health. In summary, advance care planning is about guiding the person who could be called upon to be your decision-maker about your life goals; beliefs; values; your attitudes towards treatments; and the personal and cultural issues that are important to you.

Above all, Advance Care Planning allows your voice to be heard if a time were to come when you could not make your own healthcare decisions. Advance care planning involves having good discussions with the people who could be involved in decision-making about your care in the future.

It is important to understand who will be asked to represent your views , in the event you are unable to speak for yourself. Be ready at any time to explain the purpose of advance care planning, and discuss the advantages and challenges. The Mental Capacity Act provides a number of ways for people to plan their care and support in advance.

Care staff should find out about: Advance statements. These are not legally binding but should be considered carefully when future decisions are being made. They can include any information the person considers important to their health and care.

Lasting power of attorney. This involves giving one or more people legal authority to make decisions about health and welfare, and property and finances.

Advance decisions. These are for decisions to refuse specific medical treatments and are legally binding. Providing information Give people written information about advance care planning in a way that they can understand, and explain how it is relevant to them.

If someone has recently been diagnosed with a long-term or life-limiting condition that may affect their ability to make decisions in the future, make sure they have information about: Their condition.

Support them to ask healthcare staff for more information if needed. The process of advance care planning.