Advance Statement

Overview

An advance statement is a written document where you can record your wishes, preferences, and values about your future care. It is for times when you may not be able to communicate them yourself, for example if you are seriously ill or unconscious. It is not legally binding, but healthcare professionals must consider it when making decisions about your care.

More people are writing advance statements as part of planning their future care. It is becoming a normal part of arranging care in many countries, including the UK.

Anyone can make an advance statement. It can be especially helpful for people with long-term conditions, older adults, or anyone who wants to make sure their voice is heard even if they cannot speak later.

Symptoms

Common symptoms

• You want your family and care team to know what is important to you.
• You have a condition that may affect your ability to communicate in the future.
• You want to help your loved ones feel less worried about making decisions for you.

Causes

Main causes

• A personal desire to stay in control of future care decisions.
• A long-term illness that may affect your ability to communicate later.
• A wish to help your family know your preferences and avoid difficult guesses.
• A desire to record your values, beliefs, or religious practices for your carers.

Risk factors

• You are older or have a serious, progressive medical condition.
• You are about to have a major treatment or surgery.
• You have strong personal, cultural, or religious wishes about your care.
• You want to reduce the burden on relatives who may have to make decisions for you.

When to see a doctor

See a doctor urgently if:

• If you feel pressured to make care decisions quickly and want support, speak with your GP or a healthcare professional as soon as possible.

Book a routine appointment if:

• If you are thinking about writing an advance statement, you can bring it up at your next routine appointment.
• If you have already made one, you may want to review it with your GP from time to time.

Diagnosis

An advance statement is not a diagnosis. It is a personal document you write yourself. You can do it alone or with help from someone you trust, such as a family member, carer, or patient advocate.

Tests that may be done

• There are no medical tests needed.
• Simply write down your wishes and preferences clearly.
• You can ask your GP practice or a local advice service for guidance on what to include.

What to expect at your appointment

Once written, you can give a copy to your GP, your family, and anyone involved in your care. Your GP may keep it in your medical records so it is available if needed.

Treatment

An advance statement is not a treatment. It is a way to communicate your care preferences. Healthcare professionals will take it into account when planning your care, but they are not required to follow it if it asks for something that is not clinically appropriate or legal.

Self-care at home

• Think about what matters most to you in different situations, like day-to-day routines, comfort, and personal care.
• Write in your own words, and be specific about your wishes.
• Keep the document somewhere safe and make sure your loved ones know where it is.
• Share copies with your GP and any other relevant professionals.

Medical treatments

Your healthcare team will use your advance statement to help guide decisions about your care, such as where you want to be cared for and which treatments you would prefer or refuse. They will always discuss choices with you directly whenever you are able to take part.

When is surgery considered?

If you are having a planned operation or procedure, you can let your care team know about your advance statement before the procedure. This helps them understand your preferences in case you are not able to speak for yourself afterwards.

Living with this condition

An advance statement does not change how you go about your daily life. It is a safety net that can give you peace of mind, knowing your wishes are written down.

Lifestyle tips

• Make it a habit to talk openly with your family about your care preferences.
• Review your advance statement every few years or after major life changes.
• Keep your statement simple and easy for other people to understand.

Diet and exercise

You can include any preferences about food, diet, or exercise routines in your advance statement. For example, if you follow a particular diet or want to remain active, you can mention that.

Mental health and emotional wellbeing

Planning ahead can reduce anxiety and help you feel more in control of your future. It may also comfort family members by taking away the fear of making the wrong choice on your behalf.

Prevention

There is no illness to prevent. An advance statement helps you prepare for future changes in your health. It can help prevent confusion or disagreement among family members and ensure your care reflects who you are.

Complications

If left untreated

• Without an advance statement, your family and healthcare team might not know your true wishes if you cannot speak for yourself.
• Decisions about your care could feel harder or more stressful for the people you love.

Long-term outlook

Creating an advance statement is a positive, forward-looking step. It helps you stay in control and brings peace of mind to you and your family. It is never too early to start, and you can always change it as your thoughts or circumstances evolve.

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