What is an Advance Decision document & why would I need one?
An Advance Decision (formerly known as a Living Will) allows you to specify how you wish to be cared for and treated at the end of life in the event you are unable to make decisions because you lack mental capacity. You can draw this up yourself, but you may want to consult a solicitor or your doctor to ensure your wishes are clearly expressed.
An Advance Decision should not be confused with a Lasting Power of Attorney. An Advance Decision document outlines the end-of-life decisions you have made for yourself, whereas a Lasting Power of Attorney allows the person you have entrusted (your ‘attorney’) to make decisions on your behalf when you are no longer able to make them yourself.
In your Advance Decision you might want to include:
• Where you would like to be cared for, e.g. at home preferably
• The key people you would like involved in your care
• Your preference for a bath or shower
• Who you would like to bathe and dress you
• How you would like to be dressed
• What food you would like to eat
• Who you would like to visit you
• How you wish each day to be planned, e.g. do you want to be taken outside regularly.
• Your views and religious beliefs
Your Advance Decision allows you to communicate what treatments you would not want to receive, even if it results in your death. You need to be very clear about all the circumstances in which you want to refuse treatment, that’s why it’s good to talk through possible scenarios and options with your doctor. For example if your breathing stops, you can ask not to be resuscitated. An Advance Decision cannot be used to demand that your life be ended.
Is an Advance Decision legally binding?
In England and Wales the Advance Decision is legally binding, providing it:
• Complies with the Mental Capacity Act (2005)
• Clearly specifies which treatments you want to refuse and under what circumstances
The document will need to be signed by you whilst you are still mentally capable, and signed by a witness.
Appointing an ‘agent’
An ‘agent’ is someone who will act in accordance with your wishes. You will need to appoint a primary and secondary agent, in the event that the first person cannot be reached. This person should be aged 18 or over (16 or over in Scotland). You should make them aware of what your wishes are and that they are fully accepting of them to avoid any issues later on.
There are a number of free Advance Decision templates on the internet for you to download. If you are under the care of a hospice, ask for a copy of their Advance Decision document and ask for help completing it.