Why choose Advance Care Planning?

Living with a life-limiting and progressive illness isn’t easy and many people will feel very anxious about the future, with respect to themselves and sometimes even more so, about family members and friends. With Advance Care Planning you can benefit from improved end of life care as well as achieving reduced stress and anxiety for bereaved relatives.

Talking about the future and considering your future care needs may feel a very daunting task, but staff at the Rowans Hospice are here to help and support you in creating plans that are unique to your needs. This may include a formal Advance Care Plan document which will record your wishes and preferences and help you receive the care and support you would wish even if at some point you become unable to express your wishes. It can include documentation of treatment you would not want to receive and describe your preferences for place of treatment and care.

At Rowans Hospice, we can facilitate open conversations with your family and those who care for you. It is important to inform other health care professionals too, so everyone involved in your care knows your wishes. Our team is available to offer help and support to begin thinking and talking about your future care needs and will do all they can to ensure your wishes are then followed.

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What could an Advance Care Plan include?

  • Information related to your daily routine and whatever feels important to help you feel comfortable and relaxed, this is particularly important if you choose to be admitted under the care of a nursing team who will not know you well.
  • Your cultural and spiritual beliefs, values, and practices and how we help you to maintain these.
  • Treatments that you would not want, such as surgery, tubes, breathing machines.
  • Who you would choose to be involved in making decisions with you and potentially giving people “power of attorney” to make decisions on your behalf if you become unable to do this for yourself.
  • Where you would choose to be cared for as illness progresses; discussing this in advance will help others know your wishes and help you achieve what feels right for you and your family, such as remaining at home to die.
  • A decision when a natural death is approaching that cardiopulmonary resuscitation will not be used: allowing you to die peacefully with those who are important to you and in the right environment.
  • Who you would feel comfortable receiving care from; this may include family, informal carers, and professionals too.
  • Making provision for those you care for; this may include pets and others who may depend on you.
  • What you want to happen after your death and any specific wishes relating to the care of your body, organ donation and funeral arrangements.
  • What you would want to happen to your possessions and information about you, for example your social media profile.
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Help with your Advance Care Planning

Nursing staff and other members of the clinical team, including psychologists and the Spiritual Care Chaplain, can help you and your family talk this through and help formulate your advance care plan. This can be undertaken at home or alongside others through sessions available through the Rowans Living Well Services.

Documentation to support you to start thinking about Advance Care Planning is also available through FuturePlanning.org and AdvanceCarePlanning.org.

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Advance decision to refuse treatment

As part of your Advance Care Planning, you can inform those who are looking after you about the problems you are experiencing and what treatment or actions will help.

You can also further develop your advance care plan with an ADRT (Advance Decision to Refuse Treatment), which records specific types of medical treatment, which our team can offer you guidance and support with.

The ADRT can include:

  • Treatments you may want to refuse as known ‘side effects’ could outweigh benefit and reduce your quality of life e.g. chemotherapy or radiotherapy.
  • Circumstances towards the end of life where you would want to refuse the treatment, such as cardio pulmonary resuscitation (CPR) or ventilation (a machine that breathes for you).

Our doctors and nurses can clarify the types of treatment you may be offered and how these options will affect you, as well as identifying how realistic they are and what alternatives may be possible. The refusal of treatment requires your signature and the signature of a witness, which could be a family member or a friend.

Power of attorney

If you become too unwell to make decisions yourself, advance care planning will help those who care for you to make decisions on your behalf. Your advance care plan can be further developed by formally granting a family member or friend power of attorney. Therefore, if a situation arises where a decision needs to be made about your care and it was not covered in your advance care plan, healthcare professionals will reach out to your appointed person and ask them to make decisions that they believe would be in your best interest.
The appointed person can also manage your property, finances, and any other assets. For more information on the lasting power of attorney, see the government’s website. A Citizens Advice Service is also available through the Rowans Living Well Services if more help is needed.

If you have not appointed someone to make decisions about your care and you become too unwell to make the decision yourself, doctors and nurses will decide what is in your best interests alongside family and other people who are important to you.

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How to share your advance care plan

Once you have created your advance care plan, keep it somewhere safe, but also give a copy to all health care professionals, family and friends who are involved with your care.

Your GP can take key information from the plan and insert it in your record in a dedicated “escalation plan” section, if you give your practice permission, they will share that information to a shared care record which can be read by anyone who might be called on to attend you (for example ambulance crews or doctors and nurses providing advice and support).

If you would like any further help on advance care planning, contact us on: info@rowanshospice.co.uk or through the Life-Line’, a support and advice line to support patients, family members, friends, carers and the bereaved through the Rowans Living Well Services. Direct Dial: 023 9224 8011 (open 10:00 – 16:00, Monday – Sunday).

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