Planning for your future care (Advance / Anticipatory Care Planning)

Information for patients and carers

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...Information for you...Information for you...Information for you What is Advance / Anticipatory Care Planning (ACP)? It is your chance to discuss your thoughts and wishes for your future care. It can also help people involved in your care to understand what you would or would not want. Who needs to think about their future care? Everyone can benefit from putting their affairs in order, making a will, having insurance and so on, but what about your healthcare? If you have a long term condition or palliative care needs, this may be particularly beneficial to you. Particularly when things may start to change for example, in the last year of your life Have you thought about • Where you would like to be cared for if you are not well enough to look after yourself? • What care you may or may not want in the times to come? • You may want to ask somebody to make decisions for you in case you become unable to make them for yourself Getting help Talk to any health or social care staff such as your doctor, nurse or social worker.

For more information and an explanation of relevant terms, see pages 7 - 9 2

...Information for you...Information for you...Information for you What is an Anticipatory Care Plan? (ACP) The document used to note your thoughts and wishes is known as an Anticipatory Care Plan (ACP). Having a plan helps your family, friends and health care professionals to know what is important to you now and in the future when you may become unable to make decisions for yourself. If this time comes, anything you have written in this care plan will be carefully considered and respected. Important information contained in your ACP may be used by health professionals to help you plan your future care. You may wish to consider your preferred place of care and other important issues for many months or years before approaching the end of your life. You may not wish to do this just now and that is absolutely fine but if you change your mind at any time, please ask to talk about it.

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...Information for you...Information for you...Information for you Should I talk to other people about this? You may find it helpful to talk about your care for now and the future with your family and / or friends. This can be difficult. People may not wish to talk about it or they may not like or agree with your decisions. However, it is important to have written down what is best for you. Your family / friends may be involved in caring for you, so it may be useful to discuss any particular wishes or needs you may have with them. Your professional carers (like your doctor, nurse or social worker) can discuss this with you and help support you and your family / friends. What is an Advance Decision / Directive? You may decide to express a very specific view about a particular medical treatment which you do not want to have, should you become ill in the future. This can be a written statement, drawn up and signed by you. An Advance Decision is generally about refusal of treatment and it may be useful to talk this through with your doctor. What an Anticipatory Care Plan is not An ACP is not legally binding, however, past and present wishes are always taken into account when planning care.

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...Information for you...Information for you...Information for you What do I do now? If you wish to start a care plan, speak to your professional carer for example, doctor, nurse, social worker. When you have made decisions write them in your care plan. This may be shared with anyone involved in your care. Unless people know about your care plan and what is important to you, they may not be able to take your wishes into account. Consent to share my ACP Many health professionals may be involved in making decisions about your care. It is helpful if the information from your ACP can be shared with other people involved in your care like your doctor, nurse, social worker, home care provider and so on. It will help you to receive the care where and how you wish. If you are happy for relevant information to be shared with other services please complete the consent section of the care plan. Please keep your plan in a safe place but make sure people can find it. It may be helpful to take it with you if you go into hospital.

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...Information for you...Information for you...Information for you Who can make decisions for you when you can’t? An important part of your anticipatory care plan is that you can name someone you have chosen, who will speak for you and make decisions on your behalf if you can no longer make decisions yourself. This can be a member of your family or a close friend and is called a Power of Attorney. This may be for financial control, welfare or both. Please see page 8 for more information. Changing my mind Remember your views may change over time. You can change anything you have written in the plan, so it may be useful to review it from time to time. Just make sure you write changes in your plan and make relevant people aware of the changes.

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...Information for you...Information for you...Information for you An explanation of relevant terms ACP— the document (See page 1) Advance / Anticipatory Care Planning The term ‘Advance’ usually refers to what you may or may not want to happen to you at the end stage of your life in case you may not be able to make decisions for yourself. This applies to all people whether they have a long term condition or cancer. The term ‘Anticipatory’ refers to planning for an expected change in your health and includes advice about and how best to manage your condition. This is more commonly applied to those living with a long term condition. Your ACP will help if you should become acutely unwell. Acutely unwell Severe and usually short episodes of increased symptoms for example, breathlessness. Advance Decision / Directive A written record communicating a refusal of a specific treatment or categories of treatment. Advance Statement / Statement of wishes A verbal or written record of communication of what you would wish to happen in certain circumstances

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...Information for you...Information for you...Information for you An explanation of relevant terms Consent Only information you wish to share will be shared with your permission. DNACPR form The DNACPR form is a record of a decision that has been made in the event of a cardiopulmonary arrest (the heart stopping). Further information can be found at: http://www.scotland.gov.uk/Publications/2010/05/24095 633/11 Incapacity The inability to make decisions, communicate decisions, understand decisions, retain the memory of decisions. Adults with incapacity Act (2000) website: http://www.scotland.gov.uk/ Publications/2006/10/26103435/5 Long-term condition A condition that cannot be cured but can be managed through medication and/or therapy. Examples include, diabetes, asthma, coronary heart disease, chronic obstructive pulmonary disease (COPD).

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...Information for you...Information for you...Information for you An explanation of relevant terms Key professional This may vary at different stages of your care. This person may be your GP, social worker, district nurse, hospital consultant, specialist nurse or person responsible for your care in a care home / respite care. Palliative care Palliative care is the term used to describe the care that is given when cure is not possible. As well as controlling pain and other distressing symptoms, it aims to meet the physical, practical, functional, social, emotional and spiritual needs of patients and carers facing progressive illness and bereavement. Power of Attorney An important part of your anticipatory care plan is that you can name someone you have chosen, who will speak for you and make decisions on your behalf if you can no longer make decisions yourself. This is a legal process. For more information, visit — The Office of the Public Guardian Website: http://www.publicguardian-scotland.gov.uk/whatwedo/ power_of_attorney.asp Long-term condition A condition that cannot be cured but can be managed through medication and/or therapy. Examples include, diabetes, asthma, coronary heart disease, chronic obstructive pulmonary disease (COPD).

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...Information for you...Information for you...Information for you Advance / anticipatory care planning and relevant issues can be quite complex.   We hope this booklet explains everything and helps to signpost you to additional information.  We would really appreciate your thoughts and comments about the booklet. Does it tell enough or too much? Is there anything you would add or take out ? What about the format and the sample pictures? If you wish to comment, please email either Mrs Josaleen Connolly at [email protected] or Ms Eunice Goodwin at [email protected] or phone 01563 826222 NHS Ayrshire & Arran would like to thank all the people who helped to develop this booklet.

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...Information for you...Information for you...Information for you

Your notes

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Last reviewed: March 2012 Leaflet reference: MIS12-079-GD