Advance Directives/Living Wills

Definition

• Statement made by a mentally competent adult, that gives instructions about how they would wish to be treated in the event of any future loss of mental capacity

• It made be seen as a method of extending a patients autonomy by allowing them to make decisions which they would otherwise be excluded from.

What information is needed

• No set format• Ideally witnessed by Dr or Lawyer • Should include

– Full details including any diagnoses– Clear statement of treatment to be refused– Circumstances in which the decision applies– Date you wrote or reviewed document– Signature– Ensure family/friends/docs are aware– Get a witness to co-sign– Include refusal for treatment if life is endangered

Valid if…

• Author has capacity, >18, not under duress• Fully informed of nature and consequences of

AD• Situation to which AD applies are clearly stated

and now apply• Not been amended or revoked• Author now lacks capacity• AD refuses certain treatments or specifies the

level of deterioration at which active treatment should cease

Where can I get one

• www.advancedstatement.co.uk

• http://www.barnsley.gov.uk/advanced-statement-advanced-decision

• For Barnsley can call 01226 770023

What to do if given an AD

• Make sure it is the correct pt and they were over 18 at time of writing

• Examine them and assess capacity• Must not have capacity for AD to come in to

effect• Ask for 2nd opinion• Contact any witnesses if possible (to check

capacity at time of writing) • Contact nominated proxy (no legal rights)• Check current situation is specified in AD• Carefully document all decisions

Future care planning

• Preferred Priorities for Care

• www.endoflifecareforadults.nhs.uk/.../preferredprioritiesforcare