Advance decisions (living wills)
There comes a time when we all need to think about the future and what we would like to happen if we were unable to make or communicate our own decisions.
What is an advance decision (living will)?
An advance decision (sometimes referred to as a living will) allows you to express your wishes about how you want to be treated and cared for in certain situations. It is sometimes referred to as a living will. An advance decision would become relevant if there came a time when you were unable to make or communicate your own decisions, for example if you were unconscious or if you had advanced dementia.
The term usually refers to:
- An advance statement of wishes: this explains your likes and dislikes and anything that is important for you to be comfortable. An advance statement should be considered by all those involved in providing your care, but they are not legally bound to follow it.
- An advance decision to refuse treatment: if you feel strongly that there are some medical treatments you would not want to receive in certain circumstances you can formalise your wishes in an advance decision. It allows you to refuse treatment, even if this might lead to your death. An advance decision is legally binding which means that those caring for you must follow your instructions. However it will only be used if you lose the capacity to make or communicate decisions about your treatment.
What should I think about when making an advance decision?
There are many things you should consider when making either an advance statement or an advance decision:
When making an advance statement, think about all the things that are important to you. You might like to include information on:
- where ideally you would like to be cared for, for example your home, a care home or hospice
- your dietary requirements
- foods you do and don’t like
- whether you prefer baths or showers
- what kind of clothes you prefer to wear
- the type of music you like and what you like to watch on TV
- whether you like to sleep with a light on
- the time you like to go to bed and whether you’re an early riser or prefer a lie in
- your religious or other beliefs and values
- who you want to be consulted about your care
- who you would like to visit you.
Advance decisions to refuse treatment
Think carefully about whether there are any treatments you would not want to receive in certain situations.
You should discuss your advance decision with a healthcare professional who knows your medical history and the risks and benefits of refusing certain treatments. You may also want to discuss it with your family and friends so that they understand your wishes.
An advance decision to refuse treatment:
- must be clear about the circumstances under which you would not want to receive the specified treatment
- should specify whether you want to receive the specific treatment, even if this could lead to your death
- can’t be used to request certain treatment
- can’t be used to ask for your life to be ended.
How do I make an advance decision?
Advance statement of wishes
You can record your advance statement in any way it works for you. However it is a important to give a copy of your advance statement to all those involved in your care – especially your care staff, GP and medical team so that they know your wishes.
Advance decisions to refuse treatment
An advance decision does not need to be in writing unless you are refusing potentially life-sustaining treatment. However, it is good practice to write it down and give a copy to your loved ones and all involved in your care. Your GP and medical team must know about your advance decision so they can include it in your medical notes. You should review it regularly, and can change it at any time. You must make sure that you clearly communicate and record these changes, being sure to date and sign it.
If you want to refuse potentially life-sustaining treatment your decision must be in writing, signed, witnessed, and include the statement ‘even if life is at risk as a result.’
The rules about how an advance decision and Power of Attorney interact can be complicated. It’s best to seek legal advice about setting up an advance decision.
What should I do next?
For more information call Age UK on 0800 055 6112