It’s natural to find it difficult or upsetting to think about the future. But you might find that making plans helps you feel more prepared for what the future may hold. It can also reassure you about the future for your family. Although it might be very hard, it is a good idea to talk about your wishes to those close to you, and write them down, so that they can understand what is important to you. It also means that, if you are ever in a situation where you can’t make decisions or speak for yourself, your healthcare team should know what you want.
Find out more about planning for the future from Dying Matters and Compassion in Dying. Macmillan Cancer Support and Marie Curie also provide information about what will happen in the last few weeks and days of life.
Thinking about your future care
Think about what care you would like to receive in the future. This is called advance care planning. Planning your care can help to make sure you get the care you want. But not everyone wants to think about what care they want in the future, and it’s not something you have to do.
Advance decisions and advance directives
In England and Wales, an advance decision to refuse treatment allows you to record any treatments you wish to refuse in certain circumstances. It’s used if there’s ever a time when you are unable to make a decision for yourself, or if you can’t communicate what you want. For example, if you were unconscious, or were being given sedatives at the end of your life, you might decide in advance that you wouldn’t want treatment to prolong your life.
An advance decision to refuse treatment is legally binding. This means your doctor or nurse would have to carry out your wishes.
You can’t use an advance decision to ask for specific treatments, or to ask for your life to be ended. If you refuse treatment within an advance decision your doctor or nurse will still make sure you are comfortable and free of pain.
In Scotland, you can make an advance directive to say what treatments you would refuse, if you were unable to decide for yourself or communicate your wishes. An advance directive isn’t legally binding, but your doctor or nurse would need to take it into account when making a decision on your behalf.
In Northern Ireland, advance decisions or directives aren’t legally binding. But it’s still a good idea to record what treatments you would refuse if you couldn’t decide yourself or communicate your wishes. Your doctor or nurse should take this into account when making a decision on your behalf.
It’s a good idea to put your advance decision or advance directive in writing – then it’s clearer to your doctor or nurse, and will be easier for them to follow. If your advance decision contains a refusal of treatment that will keep you alive, it must be in writing.
Speak to your partner, family, doctor and nurse about what to include. Refusing certain treatments may put your life at risk, or cause you discomfort. Your doctor can talk to you about this in more detail, and help you think through the consequences of any decision carefully. Make sure your doctor or nurse knows about it, so that they can follow your wishes.
You can change your advance decision or advance directive at any time. It’s a good idea to review it regularly to make sure it is still what you want.
An advance statement is a general statement about anything that is important to you in relation to your future health and wellbeing. It can include some of the following:
- your wishes and preferences about the type of care you want
- who you would like to be asked for a decision about your care, if you are unable to make it yourself
- where you would like to be cared for – for example, at home, in a hospice or hospital
- where you would like to die.
An advance statement isn’t legally binding in the same way that an advance decision is. But your doctor does have to take your advance statement into account when making any decision on your behalf – although it might not always be possible for them to follow your wishes.
Even if you say in your advance statement who you would like to make decisions on your behalf if you can’t, your doctor doesn’t legally have to follow what that person says. The only way to give another person the legal power to make health or care decisions on your behalf is by making a Lasting Power of Attorney for Health and Welfare.
Support in making decisions
These can be very difficult decisions to think about. You don’t have to make any decisions if you don’t want to. But if you think about these things early on, it helps your doctor or nurse plan your care according to your wishes. They will discuss these issues with you and keep a record of your decisions. You can also talk to your family about what you want, and help them understand your wishes. If you change your mind at any time, you can change your plans or cancel them.
Age UK and Compassion in Dying have more information about making decisions about your future care.
Making a power of attorney
A lasting power of attorney is a legal document. It lets you appoint someone to make decisions on your behalf if you are unable to, for example, if you are unconscious. You can appoint one or more people to make decisions for you. In the legal paperwork, they are called an attorney. They should be someone you trust, like a family member or friend.
There are two separate types of lasting power of attorney.
- A property and financial affairs lasting power of attorney covers issues around money and property.
- A health and welfare lasting power of attorney covers decisions about your health, personal care and welfare.
Age UK and Compassion in Dying provide information about making a lasting power of attorney. You can find more information and the forms you need to fill in from the GOV.UK website.
Making a Will
By making a Will you can make sure that your property and possessions are passed on according to your wishes. If you die without making a Will, the state decides who inherits your property. You don't need a solicitor to make a Will, but using one makes sure that the correct legal processes are followed and your Will is valid.
Age UK and Macmillan Cancer Support have more information about making a Will.
Making a funeral plan
Some people want to be involved in decisions about their own funeral, such as whether they will be buried or cremated, or what music and readings to have. Some people take comfort in making these plans. But others prefer not to think about this.
If you do want to think about your funeral, you could discuss your wishes with your family, or write them down for them. Some people include instructions for their funeral in their Will. You can get more information about planning a funeral from Age UK and GOV.UK