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Who will speak for you?

Who will speak for you when you are too ill to make your own healthcare and life decisions? How will you communicate how you want to be cared for in your last days or who will write your eulogy at your funeral? These are important decisions that can easily be forgotten about and left until it is too late.

What is an Advance Care Plan?

An Advance Care Plan (ACP), is a personal statement of wishes, that should you be unable to speak up for yourself at any point in your last days, then it can do so for you. The purpose of an Advance Care Plan is to ensure that the wishes of the person who is dying, are, as far as practically possible, respected and acted upon.

When should my ACP be written?

An ACP should be written when a terminally ill individual is given a life-limiting prognosis (usually six to 12 months left to live), and especially should that individual’s mental capacity change, whereby they would not be able to speak for themselves.

However, not one of us can say what will happen in the future. Would our loved ones know what we would want for ourselves? Therefore when it should be written depends on each individual. Many people have their Advance Care Plan written with no current worry of a life-limiting condition, but would rather their wishes be known, ‘just in case’.

Who should be present when writing the ACP?

The only person who needs to be present is you. However, it would be wise to include your next of kin or significant other so that they are aware of your wishes and where the ACP is held, should it ever be required.

It would also be helpful for your healthcare professional to be made aware of your ACP, they would then be able to guide you, should you have any specific medical questions.

What should the ACP be written on, and is it a legal document?

The ACP can be written on the back of an envelope or a postcard, however, there are recognised formal documents that can be used. They can act as a prompt for what you may wish to include and usually have space on them for personalisation.

Below are some links to the documents that you may wish to consider for yourself:

www.mydecisions.org.uk

www.newdevonccg.nhs.uk

www.dyingmatters.org

www.nhs.uk/planners/end-of-life-care/pages/planning-ahead.aspx

www.goldstandardsframework.org.uk/advance-care-planning

https://www.mariecurie.org.uk

www.compassionindying.org.uk

An ACP is not a legal document as such, however, it is a document that will be acknowledged and respected by those professionally caring for you at the end of your life, and as far as practically possible, will be adhered to.

What can be included within the ACP?

What needs to be asked is “what matters to you?”. You should consider the following questions when writing your Advance Care Plan:

  • Where, if practically possible, would you like to be cared for should the time come when you or your loved ones are unable to care for yourself?

  • Who would you like to be with you?

  • Who knows, apart from yourself, what your wishes are?

  • What are your funeral plans?

  • Do you have any policy plans to cover the cost of your funeral, and where are they held?

  • Do you have any other insurance policies, where can they be found and who knows about them?

  • Have you made your will, and if so, where can it be found?

What can NOT be included within the ACP?

You cannot make any requests for or against medical care that may be required at the end of your life. This can be made, but on a different document, which has legal standing, called ‘An Advance decision to Refuse Treatment’. Speak to your medical professional for more information.

Does the ACP cost anything?

No, they are free to download from the sites offered above.

How will professional medical and nursing staff know that I have an ACP if I am unable to tell them for whatever reason?

This is why we have launched unique ACP cards and key-fobs. By having your ACP card on you in your purse or wallet or on your keys, it will be easily identifiable that you have an ACP.

If the worst were to happen, St Luke’s is ensuring all healthcare staff know to look for the card/key-fob should the patient not be able to communicate that they have an ACP.

The ACP cards and key-fobs will be available at our specialist unit at Turnchapel, at Derriford Hospital and at all St Luke’s education sessions. They will also be available at local nursing and residential homes.

For more information, please contact: education@stlukes-hospice.org.uk or call 01752 964250.

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