Documenting and sharing your wishes and decisions will help people know what you want or not want. Make sure you share your wishes and choices with your family, friends and those who matter to you as well as health and social care professionals.
Have a look at the information below. There are links for examples and suggestions at the bottom of the page.
Advance Statements
This is way for you to make generalised statements describing your wishes and preferences about future treatment and care so that people know. For instance where would you like to be looked after such as your home, in a hospital, in a nursing home or hospice. Whilst it is not legally binding if you have a Lasting Power of Attorney they must take your Advance Statement into account when deciding what is in your best interest.
Advance Decision to Refuse Treatment (ADRT)
This is a formal way for you to write down and share any decisions you make about treatments that you do not want in the future.
Lasting Power of Attorney
You can choose to give another person (or more than one) legal authority (making them an ‘attorney’) to make decisions on your behalf about your care if a time comes that you are not able to make your own decisions. This is a legally binding document.
It is up to you whether you choose to complete all three documents or just one. The documents will only be used if you are unable to make or communicate a decision for yourself.
“My children and my husband now know exactly what I want. My advance care plan, my funeral plan and my will have all been sorted, and my eldest, now 10, has made it very clear she is after my pair of pearl and gold earrings!”
Source: Mireille Hayden, Dying Matters
Further resources are available here
Examples of document templates can be found here
How can my fridge help? The Message in a Bottle Scheme for important forms.
It may not be deemed practical for a person to carry a DNACPR or ADRT form at all times but we would encourage this whenever possible, and for family members, friends, neighbours to also be aware of these wishes and perhaps even have a copy of the form available or photograph them with their phone. A few patients have in the past ordered medical alert bracelets, as an additional form of communication: these can be engraved with a message, such as: “I have an Advance Care Plan” or “Please read my Advance Decision to Refuse Treatment form in my purse”. http://www.amazon.co.uk/Medic Alert Bracelets
In a home situation, there is the so-called Green Bottle scheme, with a sticker inside the front door, and it is well established in Wales: paramedics look for a green sticker inside the front door routinely when they go on house calls, which alerts to the presence of a green bottle in the fridge. Then they know there is something important they have to check for. Anyone can put their DNACPR form or ADRT in a green bottle in the fridge, or a written instruction as to where to find all the important forms in the house (“DNACPR is in living room on bottom left shelf”). The Lions website has more information on this. (1) The UK Lions Clubs supply the bottles to health centres, doctors’ surgeries and chemists, but other green bottles can also be used. The green Lions bottles are also available directly from Lions Clubs (0845 833 9502 for details of your local club).
The recording of DNACPR status on the electronic digital individual patient record is currently being pursued and will assist in the confirmation of a person’s CPR decision across agencies when developed. Work is also ongoing to develop an electronic record of advance/future care plans for Wales with electronic access to all healthcare providers (with patient’s consent), including patients.
