Why advance care planning is important (England and Wales)
Planning ahead is important because it’s not always possible for healthcare or other professionals to know exactly how you would like to be cared for in certain situations.
This could be the case if you were unwell and unable to talk to them; or if you were unable to make decisions about your care, for example if you were unconscious.
The ways people can plan ahead vary across the four nations of the UK (England, Scotland, Wales and Northern Ireland) and there are also some legal differences. The web pages in this section are about the ways people can plan ahead if they live in England and Wales. If you live in Scotland or Northern Ireland you should ask a healthcare or legal professional to give you information that’s relevant to that country.
If you haven’t planned ahead and can’t tell people what you want, professionals and other carers, such as family and friends, will act in your best interests. This means they will plan care for you based on their experience, their understanding of your situation and discussion with your family and friends. This is known as a best interests decision. They will take into account your past wishes, your beliefs and values - if they can find them out - and anything else you would be likely to consider if you were able to. However, even taking these into account, a best interests decision won’t necessarily be the same as the decision you would have made yourself. For example:
You may already have decided that if you were seriously ill and not likely to recover, you wouldn’t want your medical team to restart your heart and breathing (resuscitation), if they were to stop.
You might not want to be given antibiotics if you had a serious infection.
However, in an emergency, if your wishes weren’t recorded, healthcare professionals may make a decision to attempt to restart your heart if it stopped or give you antibiotics if you had a serious infection, if they felt that this treatment was in your best interests.
If you were at home when an emergency happened, it’s likely that you would be admitted to hospital if the emergency services were called. This could mean that you won’t die in the way you would have preferred or in the place you would have liked. For example, you may have wished to die peacefully in the comfort of your own home with your family close by, and not in hospital.
Even your closest family and friends may not know exactly how you would want to be cared for if you haven’t told them in advance. Healthcare professionals may ask them to help make decisions on your behalf, which may make them feel anxious. However, if you’ve planned ahead, your family and friends can help make sure you get the care you want, which can be reassuring. This can help them at a time when they may be trying to come to terms with your illness and experiencing many different emotions.
Only you are the expert on you. If you plan your care in advance you’ll know that your care will be right for you. It can also help you to feel more in control of your life. You will still be able to alter your plans if you change your mind later on.