Below are answers to some commonly asked questions about advance care planning.
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What is advance care planning?
Advance care planning is the process of exploring what matters to you and sharing that information with your loved ones and your health care team so treatment and care plans can support what is important to you.
An advance care plan includes what is meaningful to you, such as people and pets, your values and the ways you would like those caring for you to look after your spiritual and emotional needs. It will also tell your loved ones and medical staff about the treatment and care you want if you are no longer able to tell them yourself.
It can also cover what sort of funeral you would like, whether you want to donate your organs, whether you want to be buried or cremated, where your important papers are and whether you have in place an enduring power of attorney or advance directive.
Why is advance care planning important?
Many families don’t talk about death and dying until a loved one is very unwell or unable to communicate. Many people spend their last few hours unable to tell their family or health professionals their wishes.
Having an advance care plan helps your loved ones understand what is important to you and to make decisions on your behalf.
An advance care plan is an important gift as it can relieve the burden for your loved ones of having to make decisions on your behalf.
Who should do an advance care plan?
Advance care planning conversations are for everyone. All competent adults are encouraged to create their own advance care plan. You never know when you may have a health crisis and are unable to speak for yourself.
Take some time to think about what’s important to you. You may not need an advance care plan for many, many years, but you’ll be glad you have it.
Think about having an advance care plan for you and for your parents or your adult children. You need to find out what matters to them. Start the conversation. There may be a time when it’s difficult for them to make decisions for themselves, so help them to start talking about what is important to them now. By having the conversation, you’ll be in a better position to understand their thoughts and feelings and to support them.
When should I do an advance care plan?
Any time is a good time to think about and share what’s important to you about your future health care. Advance care planning becomes even more important if you have some health problems, have been diagnosed with a disease or illness, are getting older, or simply have strong views about what you do and don’t want.
You might not fill in everything now (such as your specific treatment or care) but these can be completed in the future.
Who should I involve in preparing my advance care plan?
You should talk to your doctor or specialist (particularly if you have been diagnosed with a serious illness) and other members of your health care team as well as your loved ones about the treatment and care you want.
How do I prepare an advance care plan?
There are lots of resources available to help you think about and complete an advance care plan, click here for more information.
What is the role of my health care team?
The role of your health care team is to listen to what matters to you and to talk about and help you plan for your future care and treatment.
An advance care plan tells your health care team about the treatment and care you want if you are no longer able to tell them yourself.
You may need a health professional’s help to fill out the ‘Specific Treatment’ and ‘Care Preferences’ section of your advance care plan.
What happens to my advance care plan once I’ve completed it?
An advance care plan needs to be accessible to your health care team and your loved ones. With your consent, your doctor can forward it to others involved in your care.
In some parts of the country, your advance care plan can be made available electronically to those caring for you and most district health boards are working towards this.
In the meantime, you should give a copy to your GP and any other health professionals you see regularly. Importantly, you should share the information in it with your loved ones and ensure those closest to you have a copy.
You should take a copy of your advance care plan with you to planned hospital admissions.
Will everything I write in my advance care plan be done?
Usually your health care team and loved ones will try and fulfill what you have documented as your preferences if you are no longer able to communicate with them. However, in some instances this is just not possible. For example, you may document you wish to remain at home when you are dying, but even with help your loved ones may not be able to manage the care you need. This may mean you are admitted to a hospital, hospice or care home.
It is also important for you to understand that medically futile and/or inappropriate treatments will not be administered, even if this is your expressed preference.
What if I change my mind about something in my advance care plan in the future?
Advance care plans should be reviewed and updated regularly as and when situations change.
You can go back and add to your plan as often as you like and change your decisions at any time.
It’s a good idea to review your plan annually, just to make sure your views, thoughts and wishes are the same and have been documented.
How is my advance care plan used if I am no longer able to speak for myself?
When your health care team believes there are no further treatment options that will benefit you, they will offer you care that helps with your symptoms.
Your advance care plan should include what’s important to you for your end-of-life care. This might include things like taking out tubes and lines and stopping medications that aren’t adding to your comfort, and attending to your spiritual needs.
It is important for you to understand that medically futile and/or inappropriate treatments will not be administered even if this is your expressed preference.
It may include where you would like to be cared for towards the end of your life, such as at home (and where that is for you), in hospice or in hospital. It may also include whether you would like to be buried or cremated, whether you would like your organs donated and any funeral or life celebration ceremony you would like.
What is an advance directive?
An advance directive (sometimes called a ‘living will’) is a statement about your future medical care if you are unable to make decisions. It usually sets out the circumstances where a person would wish certain care to be withheld and may be legally binding on medical professionals under those circumstances.
Ideally, you should discuss an advance directive with your doctor so that you have good information prior to making your decision. This will also give any doctor treating you confidence to follow your advance directive in the future, knowing you made a fully informed decision.
An advance directive doesn’t have to be prepared by a lawyer, written in a particular way or even written down at all. It can be verbal. However, it must meet certain criteria to legally bind your health care team to withhold medical care.
An advance directive may be included in an advance care plan.
What is an enduring power of attorney?
An enduring power of attorney is the appointment by you of a person to make decisions on your behalf if you are unable to make or communicate those decisions yourself. It is a formal document which is prepared by and signed in the presence of a lawyer.
The person you appoint as power of attorney may be a close member of your family/whānau, a friend or anyone else you choose. It is important this person knows your wishes, feelings and values to help them make the best decisions on your behalf if they need to. It is a good idea to include this person in discussions about your advance care plan, particularly those relating to future treatment options.
There are some decisions that by law a person with an enduring power of attorney cannot make, including refusing consent to standard medical treatment intended to save that person’s life or to prevent serious damage to their health.
A person with an enduring power of attorney cannot make an advance care plan or advance directive for the person who has appointed them.