Making plans about your future care

It can be useful to think early on about how you want to be cared for in the last weeks and days of your life. As you become less well, you may be less able to make decisions about your care or tell your doctors or nurses what you want.

The earlier you think about what you would like, the easier it is for your healthcare team and those close to follow your wishes. This can be difficult to think about, but it can help you feel more in control. Think about what’s important to you. You may want to talk to your family about your wishes.

You can talk to your doctors or nurses at any time about how you would like to be cared for in the last weeks and days of your life. You don’t have to wait for them to speak to you about this.

Recording your wishes

Ask a member of your healthcare team to help you record your wishes, such as your GP or a palliative care nurse. They will record your conversation in your medical notes or in a personalised care plan, so the whole healthcare team know what your wishes are.

Your personalised care plan may include details of your wishes, where you would like to be cared for, and the care you need now and may need in the future. There are different ways of recording your wishes, depending on the type of decision you want to make.

Advance statement

An advance statement is a written record of your wishes for your future care. It is also called an advance care plan, future care plan or preferred priorities for care. This means there is a guide if you become too ill to make decisions for yourself. You can ask someone from your medical or palliative care team to help you write it.

You can include anything that is important to you, such as:

• where you would like to be cared for
• treatment you would or wouldn’t want to receive in an emergency
• religious or spiritual beliefs that you would like to be reflected in your care
• cultural practices that are important to you, before and after death
• for LGBT+ people, ensuring that your partner is fully recognised in care and funeral decisions
• for transgender people, access to trans healthcare at the end of your life, and respect for your identity
• where you would like to die
• who you want to be with you when you die.

Keep a copy of your advance statement. Give copies to your medical teams, GP and people important to you, so they all know your wishes.

An advance statement is not legally binding. Although everyone will do their best to follow your wishes, this is not always possible. So do think about what you want to happen if your preferred choices are not possible.

You can write your own advance statement or use a template. Compassion in Dying has a template on their website.

Advance decision to refuse treatment

This is sometimes called a living will. In Scotland, it is called an advance directive. It allows you to record treatments you do not want to receive if you can’t make or communicate a decision about your care in the future. For example, you may not want treatment to extend your life once your cancer advances to a certain stage.

You can’t use an advance decision to ask for a specific treatment, only to say you do not want a treatment. You can update an advance decision at any time, for example, if you change your mind or if your health changes.

An advance decision is legally binding in England, Wales and Northern Ireland. In Scotland the decision is not legally binding but should be taken into account by your doctors. Compassion in Dying has an online template for an advance decision.

Deciding about resuscitation

As part of the advance decision to refuse treatment, your healthcare team may talk to you or your family about a ReSPECT or DNR (do not resuscitate) form. These forms are used to record a person’s decision not to be resuscitated. Resuscitation is the treatment given if your heart stops beating, or you stop breathing. This can be a difficult decision to make, and your healthcare team will talk you through it in detail. You may want to talk to those closest to you about this decision.

It’s important to make sure that your GP is also aware of your wishes to refuse treatment.

Lasting Power of Attorney

A Lasting Power of Attorney is a legal document. You can name one or more adults you trust to make decisions on your behalf if you are not able to yourself.

Types of Lasting Power of Attorney

In England, Wales and Scotland, there are two types of Lasting Power of Attorney. One allows someone to make decisions about your health and welfare. The other type is for your property and finances.

You will need to register the Power of Attorney, which will involve paying a fee. It can take up to 20 weeks to register, so it is best to think about this as early as you can. You can find out more at GOV.UK. You may also want to get advice from a solicitor, or from Citizens Advice.

In Northern Ireland, there is an Enduring Power of Attorney for your property and finances, but there isn’t one for making decisions about health and welfare. If you are no longer able to make decisions about your care, your healthcare team should speak to the people close to you. But they don’t legally have to follow these wishes.

Tell the person you have appointed as Power of Attorney if you have an advance statement or advance decision to refuse treatment.

Published August 2024

Review date August 2027