Advance Care Planning (ACP) is a process of discussion between an individual and their care providers irrespective of discipline. The difference between ACP and planning more generally is that the process of ACP is to make clear a person's wishes and will usually take place in the context of an anticipated deterioration in the individual's condition in the future, with attendant loss of capacity to make decisions and/or ability to communicate wishes to others. It is recommended that with the individual's agreement this discussion is documented, regularly reviewed and communicated to key persons involved in their care.
In the context of patients near a time when end of life care is likely to be needed St Wilfrid's Hospice is keen to support patients to make advance care plans. ACP is strongly supported by the National End Of Life Care programme (NEoLCP) http://www.endoflifecareforadults.nhs.uk/ and links are made from our website to the resources of the NEoLCP.
Description of advance care planning
The NEoLCP has a full description of Advance care planning:
http://www.endoflifecareforadults.nhs.uk/assets/downloads/factsheet002.pdf
Guide to advance care planning
A useful guide to Advance care planning is published by the NEoLCP:
http://www.endoflifecareforadults.nhs.uk/publications/pubadrtguide
Main elements of advance care planning
Many areas may be considered by patients as part of Advance care planning. The main areas include:
- Special wishes, preferences or concerns regarding future care
- Preferred place of care and preferred place of death
- Lasting Power of Attorney for Health and Welfare
Writing a will
- Advance Decisions to Refuse Treatment - see below
- Cardiopulmonary resuscitation - see separate web page (DNACPR).
- Supporting patients making advance care planning decisions
The NEoLCP has produced a booklet called Planning Your Future Care: A Guide which helps patients understand the process of ACP and may be downloaded from Planning For Your Future Care - A Guide NEOLCP.
Patient held record of advance care planning
Whilst having ACP discussions with a patient and their family is important it is also vital to communicate the decisions with healthcare professionals. Health professionals in West Sussex have developed a single A4 sized patient held record with may be downloaded from Planning Future Care - Wishes and Preferences for My Future Care.
Advance Decisions to Refuse Treatment
Advance Decisions to Refuse Treatment (ADRT) are statutory instruments created under the Mental Capacity Act and as such, if considered valid, are legally binding. ADRT is the modern term encompassing Living Will and similar terms. There are useful NHS website links here http://www.endoflifecareforadults.nhs.uk/publications/pubadrtguide and http://www.adrt.nhs.uk St Wilfrid's has a pdf version of the ADRT form which may be downloaded from (ADRT). The form may be completed online and saved if required.
