Palliative Care Wales
D - Document

wIPADS

Advance Care Planning

Document the patients wishes

There are a variety of ways to record a patient's wishes.

  1. 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.
  2. 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.
  3. 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
  4. 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

ADVANCE CARE PLANNING DOCUMENTS - Forms

PREFERRED PRIORITIES OF CARE (PPC)

RBID - Record of Agreed Best Interests Decisions

Advance Emergency Treatment Plan

ADVANCE DECISION TO REFUSE TREATMENT (ADRT) - Info for Professionals

ADVANCE DECISION TO REFUSE TREATMENT (ADRT) - Forms & Tools

LASTING POWERS OF ATTORNEY (LPA) - Info for Patients

DNA-CPR FORM