WHAT IS ADVANCE CARE PLANNING AND WHY IS IT IMPORTANT?
Advance care planning is a process of formal decision making to help patients establish decisions about their future care which takes effect when they lose capacity to make decisions for themselves.1 It is a voluntary process and a written record of patients’ wishes that can be referred to by carers and health professionals in the future. Previous terms and concepts used in the UK include ‘living wills’ and ‘advance directives’. Advance care planning is important in identifying early palliative care needs and recognising the end of life.2 Other benefits include less aggressive medical care and an improved quality of life near death. It also helps families prepare for the death of a loved one, resolve family conflict, and cope with bereavement.3
ADVANCE STATEMENTS, ADVANCE DECISIONS TO REFUSE TREATMENT, AND LASTING POWER OF ATTORNEY
Advance statements (sometimes known as statements of preferences) can be about either medical treatment or social aspects of care and are not legally binding, but have to be taken into account when decisions are made about the patient after they lose capacity. They can be either verbal or written.4
Advance decisions to refuse treatment are legally binding documents which allow patients to refuse specific treatment if they lose capacity. Patients can refuse medical and nursing treatment in advance but not basic care such as the offer of food and drink by mouth. Verbal wishes to refuse treatments which do not sustain life can also be recorded in the patients’ case notes (or records). An advance decision to refuse treatment only comes into effect once the patient loses the capacity to make that particular decision. The only circumstance …