Planning Future Medical Care

Many people have sensibly written a Will to communicate their wishes and instructions regarding their property after they die. But it is at least as important to consider how best to communicate your wishes in the future, if you were in the situation of being alive but unable to communicate or act for yourself.

This is most important for people with serious or progressive medical conditions, and for people at high risk of medical events. But a sudden event such as a medical event or road accident could cause loss of the ability to speak or act for anyone. Therefore it is sensible for many of us, especially those over the age of 50, to consider future medical care preferences and to discuss these with trusted friends and family.

In the absence of information to the contrary, it is often the case that family, friends and medical carers will seek to escalate care when needed to treat immediate needs, which is not always appropriate. However, the resources that follow can be used to guide and instruct those caring for you so that they can act according to your wishes, rather than guessing what would be in your best interests. These statements can be updated or cancelled if your preferences change.

You are welcome to discuss your preferences regarding cardiopulmonary resuscitation (CPR) used to re-start blood flow when the heart has stopped pumping effectively. Sometimes your doctor may advise that CPR would not be appropriate because the likelihood of success (return to good quality life) is so low and the risks (living with severe brain damage and loss of dignity at the end of life) are so high.

ReSPECT is a way of communicating your preferences in case of an emergency. The paper form can be kept in your home in a prominent place, to tell emergency healthcare responders your expectations regarding care, including CPR but also other choices, such as whether you wish to be admitted to hospital or to avoid this. To learn more, see https://www.resus.org.uk/respect/respect-patients-and-carers.

Adults who have capacity to make decisions may choose to appoint one or more trusted person(s) (usually family or very close friends) to act and speak for you, in the event that you cannot act or speak for yourself. At https://www.gov.uk/power-of-attorney you can set up LPAs for both ‘Health and Welfare’, and for ‘Property and Financial Affairs’. There is a fee for each. We recommend both. This can be done by carefully following the instructions on the website, or with help from a solicitor (who may charge an additional fee). You can express preferences (or give instructions) in the LPA. It is important that you choose people who will be able to act and speak in your best interests, and that you inform other people close to you such as family members that you are doing this.

An advance statement sets out your preferences, wishes, beliefs and values regarding future care. It is a guide for other people who might have to make decisions in your best interest, such as medical professionals and LPAs. See https://www.nhs.uk/conditions/end-of-life-care/planning-ahead/advance-statement/

You may choose to refuse particular treatments in advance, including treatments that might sustain life, such as mechanical ventilation. This is a legally binding document if it is valid and was made at a time you did have capacity to make such decisions. Your own decision in an ADRT takes precedence over a decision made in your best interests by other people. See https://www.nhs.uk/conditions/end-of-life-care/planning-ahead/advance-decision-to-refuse-treatment/.

You may wish to discuss these choices with your general practitioner (GP), in which case let us know here.
Your GP can help you make a decision about CPR and/or complete a ReSPECT form.

LPAs, Advance Statements and ADRTs are legal documents about which your GP can offer advice. We can also attach a copy of your completed LPA, Advance Statement and/or ADRT to your medical record.