Advance Care Plans in Northern Ireland
An Advance Care Plan is a document where you can record your wishes and preferences for your health and social care.
The web pages in this section are about the ways people can plan ahead if they live in Northern Ireland. We have other information about planning ahead in England and Wales, and in Scotland.
Documenting your wishes means that health and social care professionals know how you’d like to be cared for if you ever become seriously ill and unable to tell others what you want to happen. Although this record of your wishes isn’t legally binding, it will be very helpful for health and social care professionals when they make decisions about your care.
Before you write down your wishes and preferences, it can help to talk through your plans with your family or a close friend. This can be particularly helpful if you want them to be involved in your care or make decisions on your behalf. You should also talk through your plans with one or two of the professionals looking after you, such as your GP or specialist nurse.
It’s important to talk to your health and social care professionals and the people close to you about whether your wishes are realistic. If they aren’t, try to think of some alternatives. For example, if you would prefer to die at home but don’t have a family member or close friend who’d be able to support you at home, it may be more realistic for you to be cared for in a care home or hospice.
It may not always be possible for your wishes and preferences to be met at the time when you become less well. For example, you may want to be cared for at home by a family member, but if they become ill or over-tired they may be unable to care for you. In this situation, health and social care professionals may be able to arrange care for you so that you can stay at home. However, if this isn’t possible they’ll plan for you to receive the best possible care somewhere else, for example in a care home or hospice.
What to include in your Advance Care PlanBack to top
As far as possible, you should include anything that’s important to you. If you’re worried about a particular aspect of your care, you can make a plan for what you would like and write this down.
For example, you could include the following:
- Where you would like to be cared for if you can no longer look after yourself, for example at home, or in a hospital, care home or hospice.
- What kind of care you would like. However, bear in mind that you can’t demand particular treatments.
- Where you’d like to be cared for when you’re dying, for example at home, or in a hospital, care home or hospice.
- Information about specific spiritual or religious practices that you’d like to be carried out or reflected in your care.
- Which family members or close friends you would like to be involved in your care.
- Who you would like to act on your behalf if decisions need to be made about your care.
- Who you would like to look after any pets.
- Whether you would like someone to tell you how serious your condition is and the likely prognosis.
Example of some of the information that may be included in an Advance Care Plan:
Your preferences and priorities
In relation to your health, what has been happening to you?
My doctors have told me that I’m now only receiving care to control my symptoms. Curing my illness is no longer possible.
What are your preferences and priorities for your future care?
If I were to become less well, I’d like my wife to be involved in making decisions about my care and I’d like to be kept fully informed about what’s happening to me.
Where would you like to be cared for in the future?
I don’t mind where I am cared for as long as my family are close by.
You will also be asked to sign and date the document.
Who can give you an Advance Care Plan?Back to top
Ask one of your health and social care professionals to give you an Advance Care Plan document. They will give you the specific document that’s used in the area where you live.
If you like, you can use this What’s important to me document [PDF, 33Kb] to make notes about your wishes for your care. These notes will be helpful when you come to record your wishes in your Advance Care Plan.
Keeping your Advance Care PlanBack to top
Always keep your written Advance Care Plan in a safe place so it can be easily found by those involved in your care. Remember to regularly review your choices and keep them up to date.
Sharing your Advance Care PlanBack to top
Share your Advance Care Plan with anyone who is, or is likely to be, involved in your care, such as a family member, close friend, GP, nurse or hospital doctor.
If you’re admitted or transferred to a hospital or hospice, take your Advance Care Plan with you so the staff know what your wishes and preferences are for your care.
Changing your mind about your Advance Care PlanBack to top
You can change your mind about your Advance Care Plan at any time, but remember to record your changes. You’ll need to let your family and your health and social care professionals know and give them an updated copy of the document.
An example of an Advance Care Plan in action - Adrienne's story
In February, my father-in-law Dennis was diagnosed with small cell lung cancer. Unfortunately, the treatment didn’t work and in August the doctors told that him that he wouldn’t benefit from any further active treatment. Although disappointed, Dennis was relieved to stop as it was exhausting him.
During the course of the next few months, Dennis was referred to the Community Macmillan Nurse who helped him and my mother-in-law, Joyce, talk to each other about the fact that he was dying.
As an ex-district nurse myself, I was keen for the district nurses to discuss with Dennis and Joyce his preferred priorities for care and write them down. The district nurses were reluctant but when I spoke again to them they said Dennis had expressed a wish to die in a hospice. I knew this was not the case as he was petrified of hospices and had previously refused to attend the day hospice centre. I asked the district nurses to go back and speak to Dennis about his wishes, and help him document them using the Preferred Priorities for Care document. One of the district nurses phoned me back to say Dennis had stated, and written down, that he wanted to die at home (and not in a hospice as the district nurses had suggested) as long as Joyce could cope. As a family we knew this was what he wanted and we all agreed to help Joyce cope.
Over the next few weeks Dennis grew weaker. GPs suggested transferring him to the hospital or hospice, but each time we were able to show them his written Preferred Priorities for Care document and insist he stayed at home.
We had nurses overnight some nights and the family took it in turns the other nights. In October, Dennis died at home, in his own bed, with his dog Murphy lying beside him and his granddaughter Lauren holding his hand. It was a great comfort to Joyce and the rest of the family to know that Dennis’s wish to die at home had been fulfilled.