wIPADS
Advance Care Planning
Document the patients wishes
There are a variety of ways to record a patient's wishes.
- The RACPaP (Record of Advance Care Plans and Preferences) is a form designed to help guide healthcare professionals through a general enquiry about all aspects of care preferences, and to record those wishes.
- The Preferred Priorities of Care form asks broader questions, and can be completed by the healthcare professional (with the patient), or by the patient themselves.
- Planning Ahead is a more comprehensive pack suitable for motivated patients and those who have approached you to make plans for their end-of-life care
- Other forms are in use such as the GSF Thinking Ahead form
Treatment plans for emergency situations e.g. haemorrhage may be made using an Advance Emergency Treatment Plan, which should be kept with the patient.
Advance Decision to Refuse Treatment
If a patient has a clear view about specific treatment(s) that they wish to refuse in specific circumstances, advise the patient about the option of making an Advance Decision to Refuse Treatment (ADRT), which is legally binding. Although this is a legal document, most lawyers would not be able to advise about the content of an ADRT. See resources below.
Lasting Power of Attorney
Advise the patient to contact a lawyer if they wish to specify someone to have the legal right to make decisions on the patient's behalf in case of mental incapacity. This would be a Lasting Power of Attorney (LPA); note that there are two optional parts to an LPA, one which gives the power to manage financial affairs, and a separate part for healthcare decisions. Within the healthcare LPA, the person must specify whether the attorney's powers include making decisions about life-sustaining treatment.
N.B. Either of the above may incur significant cost.
DNA-CPR form
If the patient does not want to receive cardio-pulmonary resuscitation in the event of a cardio-respiratory arrest, you should - after discussion with the patient - complete a DNA-CPR form to be kept by the patient in their home.
Resources
ADVANCE CARE PLANNING GENERAL - Info for Patients
- "Planning for your future care"
Patient Info leaflet. Authors: NHS End of Life Care Programme - "Planning your Future Care Together" - More Information & Advice
Patient Info leaflet. Authors: Hywel Dda ACP working group - Advance decisions, advance statements and living wills -factsheet
Patient Info leaflet. Authors: Age UK
ADVANCE CARE PLANNING DOCUMENTS - Forms
- RACPaP: Record of Advance care Plans and Preferences
Pro forma. Authors: Cwm Taf ACP Working Group - "Planning your Future Care Together" - Statement of Wishes
Pro forma. Authors: Hywel Dda ACP working group - "Thinking Ahead :: Advance Care Planning Document"
Pro forma. Authors: Gold Standards Framework
PREFERRED PRIORITIES OF CARE (PPC)
- Preferred Priorities of Care (PPC) Form
Pro forma. Authors: NHS End of Life Care Programme [as MS Word pro forma] - Support sheet 18 Preferred Priorities for Care (PPC)
Professional guideline. Authors: NHS End of Life Care Programme - Guide to Preferred Priorities for Care (for patients)
Patient Info leaflet. Authors: NHS End of Life Care Programme
RBID - Record of Agreed Best Interests Decisions
- RBID: Record of Agreed Best Interest Decisions Form
Pro forma. Authors: Cwm Taf ACP Working Group
Advance Emergency Treatment Plan
- Advance Emergency Treatment Plan (AETP)
Pro forma. Authors: Cwm Taf ACP Working Group
ADVANCE DECISION TO REFUSE TREATMENT (ADRT) - Info for Professionals
- Advance Decision to Refuse Treatment (ADRT) : A Guide for Health and Social Care Staff
Professional guideline. Authors: NHS End of Life Care Programme - ADRT Support sheet
Professional factsheet. Authors: NHS End of Life Care Programme
ADVANCE DECISION TO REFUSE TREATMENT (ADRT) - Forms & Tools
- ADRT Pro forma
Pro forma. Authors: NHS End of Life Care Programme - "Planning your Future Care Together" - ADRT
Pro forma. Authors: Hywel Dda ACP working group - ADRT Proforma with explanatory notes
Pro forma with Patient Info. Authors: MNDA/ Palliative Care ACP Working Group - ADRT on-line tool
Form - online. Authors: Dr I N Back
LASTING POWERS OF ATTORNEY (LPA) - Info for Patients
- Making a Lasting Power of Attorney (LPA)
Patient info website; downloadable application pack. Authors: Office of the Public Guardian - Arranging for someone to make decisions about your finance or welfare (i.e. LPAs)
Patient Info leaflet. Authors: Age UK
DNA-CPR FORM