Usually Coffin Club likes to get involved after someone’s already brown bread – funerals are our jam! but, sometimes we venture out of our lane as there are things around death and dying that it’s really helpful to know about and there’s a lot of acronyms out there to bamboozle and discombobulate… so, let’s dive right in with ACP – Advance Care Plan.
Pretty much what it says on the box… Thinking about your potential care needs in the future, writing down what you think your wishes would be, and making sure your important person has access to them so that they can put them in place should you be unable to make or express your decisions in the future. This is where an LPA (Lasting Power of Attorney) is important… but that’s the next blog!!
What might you include in an ACP… You can include anything you like but some things that you might consider are – How you would like to be looked after. Where you would like to be looked after should you become less well/able – would you be happy to go into a carehome? Would you do anything you could to stay in your own home? Where would you like to die?
Any spiritual or religious beliefs you would like recognised/accommodated? Who you want to spend time with. Who your care team should talk to if you become unable to make decisions yourself (LPA comes in here again).
Practical matters such as who will look after your pets.
What you would like to happen to your body after you die? Do you want a DNR (do not resuscitate) in place? Whether you have considered organ donation.
It may seem like a lot… but, once you’ve done the donkey work and put your plan in place you and your people can sit back and relax a bit, knowing that they know your wishes.
So, have a think about what the future might hold, talk to the people who are important to you and who might be left to carry your particular can, jot your wishes down and let your important people and (if you’re at that stage) the healthcare professionals involved in your care, know where they can access it. Discuss – an ACP is not legally binding, (it’s a bit like a birth-plan, your best-case scenario) so you need to be aware that sometimes what you want and what is most appropriate at the time, may not be the same.
To help you, here are key components typically covered in an ACP:
1. Personal Information
- Full name, date of birth, and contact information.
- Details of your primary healthcare provider and any specialists you see regularly.
2. Health Conditions and Medical History
- A summary of your current health conditions.
- Significant past medical history and treatments received.
- Allergies and adverse reactions to medications.
3. Values and Preferences
- Your core values and beliefs that influence your healthcare decisions.
- Preferences regarding quality of life versus longevity.
- Religious or cultural considerations that impact your care.
4. Treatment Preferences
- Preferences for life-sustaining treatments such as mechanical ventilation, resuscitation (CPR), dialysis, and tube feeding.
- Decisions regarding the use of antibiotics and other medications in critical situations.
- Your stance on blood transfusions and organ transplants.
5. Pain Management and Palliative Care
- Your preferences for pain relief and symptom management.
- Thoughts on hospice care and palliative care options.
6. End-of-Life Wishes
- Desired place of care (home, hospice, hospital) if facing a terminal illness.
- Preferences for end-of-life rituals and practices.
- Instructions for your funeral or memorial service.
7. Mental Health Care
- Preferences for mental health treatments, including counseling and psychiatric medications.
- Information on existing mental health conditions and current treatment plans.
8. Appointing a Health Care Proxy or Durable Power of Attorney
- Designation of a trusted person to make healthcare decisions on your behalf.
- Alternate proxy in case your primary choice is unavailable.
9. Communication and Documentation
- Instructions on how and when the ACP should be reviewed and updated.
- List of individuals who should be informed about the ACP, such as family members and caregivers.
- Storing and sharing your ACP with relevant parties, including your healthcare providers.
10. Legal Considerations
- Ensuring the ACP is legally binding and adheres to relevant state or country laws.
- Including any advance directives or living wills as part of the ACP.
Conclusion
An Advance Care Plan is a vital document that ensures your healthcare preferences are known and respected when you are unable to voice them yourself. By covering these comprehensive elements, you can provide clear guidance to your loved ones and healthcare providers, helping them make decisions that align with your wishes and values.
There isn’t an official template but lots of NHS trusts have a form on their websites as does Hospice UK, Marie Curie and MyWishes or @mygoodbyesapp
