Help with planning ahead
You can plan ahead in simple steps. You do not need to follow all these steps in order. Do what feels right for you and take your time.
You may already be struggling with fears and uncertainties about the future. It is important that you do not feel alone when planning ahead. Health and social care professionals can help you, as well as family or friends.
You could write down your thoughts and feelings to help with these discussions. For some people it is a relief to start planning ahead and sharing their plans.
Health and social care professionals
If you want to start planning ahead, you can talk to your:
- hospital doctors
- specialist nurse
- district nurse
- social worker
- other health and social care professional.
They will be able to tell you the best person to speak to.
Starting a conversation can feel difficult. You could say something like:
‘I’ve been thinking about making plans for my future care, in case I can’t make decisions for myself. Could you help me find out my options and explain what I need to do?’
It is a good idea to speak to a solicitor if you want to:
- make a will
- create a lasting power of attorney (England and Wales)
- create a power of attorney (Scotland)
- write an advance decision to refuse treatment (ADRT, England and Wales)
- write an advance directive or living will (Scotland).
These are important documents.
For information on finding a solicitor, you could contact
Family and friends
Try to involve people who:
- you are close to
- you can talk openly to
- could act on your behalf.
They can support you and help you to think about what you need to include. Involving them also helps make sure your wishes are carried out.
Your plans could mean they make decisions on your behalf or take more responsibility for your care. For example, if you would like to die at home, it’s important to discuss this with those close to you. You need to know if they think they will be able to help look after you, and any concerns they might have.
If they find it difficult to talk about
Sometimes family or friends find it hard to talk about a time when you will be very unwell. They may change the subject, or not want to talk about it. Try to explain why it is important for you to plan ahead, and how it would help you to talk about it.
You could try saying something like:
'I know it’s difficult, but I want to talk to you about how I would like to be cared for if I became very unwell.'
You could also ask them to read this information. Or you could write them a letter and ask them to talk to you about it when they feel ready.
Health and social care professionals can also support discussions with family or friends.
You can also join our Online Community to talk with people affected by cancer, blog about your experience and ask an expert your questions.
When planning ahead, you can talk to people about your wishes and what matters to you, but it is usually better to write them down.
A written record of your wishes (preferences) for your care and what is most important to you is sometimes called an advance care plan. If you live in Scotland it is sometimes called an anticipatory care plan.
If you live in Scotland
There are different documents that can be used. These include:
- My Anticipatory Care Plan (My ACP). Anticipatory care planning is now referred to as future care planning.
- What’s important to me.
You can also ask a healthcare professional if they have a specific document for writing down your wishes for your care or making an advance directive. These are also called living wills.
Before you write down your wishes, try to talk about your future care plan with a family member or close friend. This can be helpful if you want them to:
- be involved in your care
- help you make the best decisions about your treatment and care.
It can be reassuring for family and friends to know that you have recorded your wishes. Make sure they know where you keep your documents (see below).
It is also important to talk about your plans with the health and social care professionals looking after you. You may want to ask them how serious your illness is and what might happen in the future.
Try to include what is most important to you. The plan might include the following:
- Where you would most like to be cared for when you cannot look after yourself or when you are dying.
- What kind of care and treatments you would prefer, although you cannot request specific treatments.
- Any tests or treatments you would not want to have if you became more unwell.
- Who you would like to be involved in your care – for example, family members or close friends.
- Who you would like to make decisions about your care if you are unable to make the decisions yourself. If you live in England or Wales you might want to choose a lasting power of attorney so that others can act on your behalf. If you live in Scotland you might want to create a power of attorney.
- Any spiritual, religious or cultural practices you would like to be included in your care.
- Who should look after anyone you care for.
- Instructions about caring for any pets.
If it is not possible to follow your plan
It may not always be possible to follow your plan or wishes when you become more unwell. For example, you may want to be cared for at home by a family member. But if they become ill or too tired, they may not be able to do this. Or you may have a symptom that cannot easily be managed at home.
Your healthcare team will do their best to help you stay at home. But sometimes the best possible care for you may be in hospital, a hospice or a care home. If you are already in a care home, you may want to stay there.
Once you have completed the document, share it with people who are important to you and anyone likely to be involved in your care.
This may include a:
- family member or a close friend
- GP or hospital doctor
- specialist nurse or district nurse
- social worker
- other health and social care professionals.
Your healthcare team will keep a copy of some of the information for their records.
Where to keep your plan
Keep a copy in a safe place at home along with any other important documents. Tell people involved in your care where it is.
You might have a fridge sticker or note somewhere obvious in your home to tell an emergency doctor or paramedic where you keep your documents. Your family or carers can also help make sure your wishes are followed.
Review your plan regularly
It is important to regularly review your wishes and keep them up to date. You can change your mind at any time, but remember to record your changes. If you make changes to your plan, tell all the people involved and give them an updated copy.
You may find it helpful to use our planning ahead checklists:
Key Information Summary (Scotland)
If you live in Scotland your healthcare professionals may record some of your wishes for your care on a Key Information Summary (KIS). This is an electronic record that is created and updated by your GP. It has information about what is important to you, and your wishes for your care. It can include information about an advance directive and the main decisions in it.
If you need urgent medical help when your GP surgery is closed, other NHS staff can get this information from your KIS. Your healthcare team can tell you more about the KIS document.
Your team may also help you to complete a ReSPECT document. It records what you would want to happen in emergency situations. For example, it sets out what treatment should be given if your heart and breathing stop suddenly.
You can ask your health and social care professionals if they have a document they use.
These statements about your preferences and wishes are not legally binding. This means they cannot be enforced by law. But healthcare professionals use them to help guide their decisions about your care.
Below is a sample of the sources used in our advanced care planning information. If you would like more information about the sources we use, please contact us at email@example.com
National Institute for Health and Care Excellence. Advance care planning – A quick guide for registered managers of care homes and home care services. 2019. Available from: www.nice.org.uk/about/nice-communities/social-care/quick-guides/advance-care-planning [accessed May 2023].
National Institute for Health and Care Excellence. Decision making and mental capacity. 2020. Available from: www.nice.org.uk/guidance/qs194 [accessed May 2023].
NHS England. Universal Principles for Advance Care Planning (ACP). 2022. Available from: england.nhs.uk/wp-content/uploads/2022/03/universal-principles-for-advance-care-planning.pdf [accessed May 2023].
Healthcare Improvement Scotland. Anticipatory Care Planning in Scotland: Supporting people to plan ahead and discuss their wishes for future care. 2020. Available from: www.healthcareimprovementscotland.org [accessed May 2023].
GOV.UK. Office of the Public Guardian. Make, register or end a lasting power of attorney. Available from: www.gov.uk/power-of-attorney/make-lasting-power [accessed May 2023].
Office of the Public Guardian (Scotland). Power of attorney. Available from: publicguardian-scotland.gov.uk/power-of-attorney/power-of-attorney/what-is-a-power-of-attorney [accessed May 2023].
Citizens Advice. www.citizensadvice.org.uk [accessed January 2023].
GOV.UK www.gov.uk [accessed January 2023].
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Viv Lucas, Consultant in Palliative Medicine.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
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