Advanced Care Planning




It can be difficult to imagine becoming so unwell as to be unable to make one’s own healthcare decisions. Unfortunately, such a time may come.

Something suddenly happens, a sudden injury, a serious illness, and suddenly you are unable to act on your own behalf. At such times it is often useful to family and friends to have some guidance as to your wishes in various circumstances and also for one or more of those family or friends to have been named by yourself as having authority to act on your behalf.

Mechanisms that can be used to achieve this include:

  • Advanced Directives (sometimes known as Living Wills- but relevant for health matters only)
  • Lasting Powers of Attorney (for Health and/ or Finance)
  • Do Not Attempt Cardiopulmonary Resuscitation Forms.

Advanced Directives

The term advance directive means a statement explaining what medical treatment the individual would not want in the future, should that individual 'lack capacity' as defined by the Mental Capacity Act 2005.

The term 'living will', is somewhat misleading in that, unlike a will, it does not deal with money or property. Moreover, it can relate to all future treatment, not just that which may be immediately life-saving.

An advance directive is legally binding in England and Wales. Except in the case where the individual decides to refuse life-saving treatment, it does not have to be written down, although most are and a written document is less likely to be challenged.

Whilst the patient has capacity their word overrides anything contained in their advance directive or anything their legal representative may say.

For those deciding to complete a form, please bring a copy to GP appointment for signing and filing in your records



Lasting Power of Attorney (LPA)

A Lasting Power of Attorney is a legal document that lets you appoint people (known as attorneys) to make decisions on your behalf. It can be used if you become unable to make your own decisions.

There are 2 types of LPA

  • Health and Welfare
  • Property and Financial Affairs

You can choose to make one type or both.

You must be over 18 and have mental capacity (the ability to make your own decisions) in order to make an LPA.

LPAs can be drawn up by your solicitor, or can be completed on line or paper without legal input. The basic cost of an LPA is £110 (for each sort) if applied for directly. Applying via a solicitor will obviously increase the cost.



DNA CPR (Do Not Attempt Cardiopulmonary Resuscitation) forms

Some people reach a stage in their lives when, if they suffered sudden cardiopulmonary arrest (their heart and breathing were suddenly to stop), they would prefer not to have cardio-pulmonary resuscitation.

This is a very personal decision made by some. It is obviously important that, in such cases, the information is carefully recorded. This is done on a DNA CPR form, which should be kept in an obvious and easily accessible place in the home. You should ensure your GP knows if you have completed one of these forms so it can be noted in your records.



If you have any questions or concerns relating to these matters, then please make an appointment with your GP to discuss further.


Understanding Decision Making Authorities 2016

The term Next of Kin is often used as a euphemism for "who is the person we communicate with about you and who do we contact when you are dead"

In law the term has NO status when you are alive. It is misleading too because it does not clarify if this is the person who is your nearest relative or the person most important to you. Indeed they are often different people.

The Social Care Institute for National Excellence have circulated a leaflet which aims to explain decision making authorities and terminologies such as “next of kin” and “lasting power of attorneys”.

The leaflet clarifies how people can plan ways to ensure that their wishes are taken into account even if, at that time and through illness, they cannot make those decisions for themselves.