Advance care planning is a voluntary, person-led process of discussing and recording wishes and values for future care. It helps ensure that if a person becomes unable to make decisions for themselves, their preferences are known and respected.
Disclaimer: This information is general and does not replace individual medical or legal advice. If you require specific guidance, please consult a registered healthcare professional or a solicitor.
Planning ahead is not a single event. It is usually completed over several conversations, focusing on what matters most to the individual, and should be reviewed whenever circumstances or health conditions change significantly.
Advance Care Plan (ACP)
An Advance Care Plan is a record of a person's wishes, feelings, beliefs, and values. It is not legally binding in the same way as an Advance Decision, but it serves as a powerful guide for healthcare professionals and family members when making care decisions in the person's best interests.
It can include preferences about where they would like to be cared for (Preferred Place of Care) and where they would prefer to be at the end of their life (Preferred Place of Death). It can also detail cultural, religious, and spiritual wishes, and specify who they want to be involved in their care.
ReSPECT
ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. It is a process that creates personalised recommendations for a person's clinical care and treatment in a future emergency in which they are unable to make or express choices.
The ReSPECT form summarises conversations between the individual (or their representatives) and healthcare professionals, balancing the person's clinical needs and personal priorities.
DNACPR (Do Not Attempt Cardiopulmonary Resuscitation)
A DNACPR recommendation is a medical decision made when CPR (restarting the heart and breathing) would not be successful or would cause more harm than benefit. It is an important part of ensuring a natural and peaceful death.
A DNACPR recommendation relates only to cardiopulmonary resuscitation. It does not automatically mean that other treatment, nursing care, symptom relief or hospital assessment will stop.
Advance Decision to Refuse Treatment (ADRT)
Sometimes known as a 'living will', an ADRT is a legally binding document that allows an individual to specify particular medical treatments they wish to refuse in the future, should they lose the mental capacity to make that decision at the time. To be valid and applicable, it must meet specific legal requirements.
Lasting Power of Attorney (Health and Welfare)
A Lasting Power of Attorney (LPA) for health and welfare allows an individual to appoint someone they trust to make decisions on their behalf regarding their daily routine, medical care, and life-sustaining treatment. These appointed attorneys can only make decisions if the individual lacks the mental capacity to do so themselves.
Mental capacity and family involvement
Mental capacity refers to the ability to understand, retain, use, and communicate information to make a specific decision at a specific time. If an individual lacks capacity for a decision, it must be made in their 'best interests' by healthcare professionals, who will consult with family and relevant attorneys to understand the person's likely wishes.
Families provide invaluable insight into the person's values and history. Care planning should always involve family members when it is the individual's wish, or when they are acting as advocates for someone who can no longer communicate their own preferences.
Continue learning about end-of-life care
For a definition of end-of-life care, read What is end-of-life care? You can also compare care options and settings, understand palliative care and end-of-life care, or find practical information in support for families.
You may also find answers in the frequently asked questions.