Advance care planning overview

Overview

Advance care planning is the process of thinking about, talking about, and writing down your wishes for your future healthcare, in case you become too ill to speak for yourself. It helps make sure that the care you receive matches what matters most to you.

Many people have not made an advance care plan, but healthcare services now encourage it as a normal part of staying well. It is becoming more common, especially for people with long-term conditions.

Anyone can make an advance care plan, but it is especially useful for older adults, people with a serious or long-term illness, and anyone who wants to reduce the burden of decision-making on their family.

Symptoms

Common symptoms

• A new diagnosis of a serious or long-term illness
• Being admitted to hospital or experiencing a decline in health
• Starting to think about what you would want if you could no longer speak for yourself

Symptoms in children

• For children with life-limiting conditions, advance care planning involves parents and healthcare providers discussing and recording the child’s comfort, treatment preferences, and quality of life.

Symptoms in older adults

• Older adults often begin advance care planning after a fall, a hospital stay, or a diagnosis such as dementia.
• Sometimes the conversation is triggered by the loss of a spouse or knowing someone else who had unwanted treatment.

Causes

Main causes

• Advance care planning is not caused by an illness. Instead, it is prompted by life events such as a serious diagnosis, aging, wanting to have a voice in your care, or wanting to protect your family from tough decisions.

Risk factors

• Being over 65 years old
• Living with a long-term condition like heart disease, diabetes, or dementia
• Having had a serious health event such as a stroke or stay in intensive care
• Simply wanting to make your values known about your future care

When to see a doctor

See a doctor urgently if:

• If you have a sudden, severe health problem, call your local emergency number right away. Your advance care plan is not a substitute for emergency care.

Book a routine appointment if:

• Bring up advance care planning at your next routine check-up, especially if you are over 50 or have a long-term condition.
• Ask your doctor, nurse, or practice team if they can help you complete an advance care plan or advance directive.

Diagnosis

Advance care planning is not a medical diagnosis. It is a voluntary conversation between you and your healthcare provider, and often your family, about your values and preferences for future care.

Tests that may be done

• No blood tests, scans, or other medical tests are needed.
• You may use worksheets, discussion guides, or booklets provided by your healthcare service to help you think through your wishes.

What to expect at your appointment

A healthcare professional will ask about what matters to you, what you value, and what you would or would not want in different situations. They may help you write down your wishes and, if available, appoint a trusted person to speak for you if you cannot.

Treatment

Advance care planning is not a medical treatment. It is a way to guide your treatment. Once your plan is recorded, your healthcare team will use it when you need care and cannot make decisions yourself.

Self-care at home

• Talk openly with your family and friends about your wishes.
• Think about what gives your life meaning and what you would find acceptable in terms of medical care.
• Review your plan every year or whenever your health changes.

Medical treatments

Your plan can include preferences about treatments you would want or not want, such as CPR, feeding tubes, or ventilator support. Your healthcare team will discuss these options with you in a way that is clear and unhurried. Always ask questions if anything is unclear.

When is surgery considered?

If you are having an operation, mention your advance care plan to your surgeon and anaesthesia team so they know your wishes before the procedure.

Living with this condition

Think of advance care planning as a gift to your future self and to the people who love you. Keep your plan in a place others can find, such as with your next of kin, and make sure your healthcare providers have a copy.

Lifestyle tips

• Keep a copy of your advance care plan in your bag or wallet, and a note in your phone's emergency settings.
• Tell your family and close friends where your plan is stored.
• Update your plan after major life events, such as a new diagnosis or the loss of a loved one.

Diet and exercise

Eating well and staying active are important for overall health, but they are not directly part of an advance care plan. Staying as healthy as possible can give you more time to enjoy life and may reduce the urgency — but planning still matters.

Mental health and emotional wellbeing

Thinking about future illness can feel overwhelming or sad. It is normal to have mixed emotions. Talk to your healthcare provider or a counsellor if you need support. If you experience a mental health crisis, contact your local crisis service or emergency number for immediate help.

Prevention

Advance care planning cannot prevent illness or injury, but it can prevent unwanted treatments, confusion, and family disagreements during a health crisis.

Vaccines

Staying up to date with recommended vaccines can help you stay healthier, which may delay or prevent some serious illnesses. This is separate from advance care planning but still important.

Screening programmes

Routine health screenings for conditions like high blood pressure or certain cancers can help detect problems early. No special screening test is needed for advance care planning.

Complications

If left untreated

• Without an advance care plan, family members may have to guess what you would have wanted, which can cause stress and guilt.
• You may receive medical treatments that you would not have chosen if you had been able to speak for yourself.
• Healthcare teams may provide care differently when they do not know your values or wishes.

Long-term outlook

Making an advance care plan brings peace of mind. It encourages honest conversations with the people you trust and helps ensure your future care reflects your own values. It is a positive step that many people find reassuring and meaningful.

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