Expressing healthcare wishes at the end of your life

Advance care planning allows you to specify your preferred or required care or treatment in the event you are unable to speak for yourself, at the end of your life.

Advance care planning includes but is not limited to:

• Lasting Power of Attorney
• Health & Welfare
• DNACPR (Do not attempt cardiopulmonary resuscitation) / DNR (Do not resuscitate)
• Advance Decision to refuse treatment
• Advance statement 
• Treatment Escalation Plan (TEP)
• Resuscitation Decision Record

These are legally binding documents that may need to be signed and dated by yourself and countersigned by a witness (e.g. your GP).

Paramedics and healthcare professionals are required to take note of your requirements and can be taken to court and suffer consequences if they ignore your wishes - much like the case of Brenda Grant from Nuneaton

- https://www.bbc.co.uk/news/uk-england-coventry-warwickshire-42240148

Why would someone have an Advance Care Plan?

An Advance Care Plan allows you to make your desires clear if you require treatment when you are unable to communicate for yourself. Your written wishes will legally override the opinions of any doctor or family member, and whilst you cannot dictate what treatment you want to be administered, an Advance Care Plan does allow you to refuse treatments.

An Advance Care Plan may be a controversial topic, it means different things to different people. If it can be openly and honestly discussed with your loved ones it will set expectations within families. It can also help to decrease any possible objection and concerns amongst family members at what will already be a difficult time.

What should I specify in my Advance Care Plan?

An Advance Care Plan can capture many possible scenarios relating to your care depending on your medical circumstances. 

Some examples we hold at MedicAlert include:

• A Do Not Resuscitate order (also known as a DNR)
• Refusal to be on a life support machine or any life-extending treatment
• Refusal of any blood transfusion (e.g. due to religious beliefs)
• Specific hygiene preferences when in a coma e.g. to have a carer of the same gender washing you
• Exclusions of certain medications due to the side effects
• Prioritising dignity and quality of life, over prolonging its duration at any cost

How will the health care professionals find out about my Advance Care Plan?

If you chose to store your Advance Care Plan documents with MedicAlert, we will engrave the relevant words onto your medical ID jewellery. A healthcare professional will identify your jewellery and then be able to call the emergency line on the back of the disc and access the details of your Advance Care Plan documents. Storing documents with MedicAlert makes life easier and much simpler.

If you ever want to update any information you would simply need to send an updated copy to replace the copy in your record. This quick connection allows for immediate access; an extremely valuable benefit when it comes to wishes such as DNACPR (Do not attempt cardiopulmonary resuscitation).

If you are not a MedicAlert member you could rely on paper versions given to your family, GP or solicitor. You would also need to keep a master version for your own records, with a list of the people that have a copy. If you ever want to update these documents, you will need to ensure each person holds the current version to show to the relevant medical professional in an emergency for them to honour your wishes.

There are obvious issues related to managing copies and versions of a printed document which could potentially diminish the authority and effectiveness of the Advance Care Plan. So, by storing your documents with MedicAlert, it is easier to ensure healthcare professionals will have access to the latest copy of your documents whenever they are needed.

How do I join MedicAlert and store my Advance Care Plan?

To become a MedicAlert member, simply sign up online or call one of our membership service advisors (01908 951045) they will be happy to walk you through the steps of making an account or make one for you, including adding the relevant documents and deciding the wording on your medical ID. 

For assistance and preparation of an Advance Decision, please refer to ‘Compassion in Dying’

Find out more:

• BBC Radio 4 interview - 'How to make sure your last wishes are respected'
• BBC Radio 4 show - 'We need to talk about death'
• The story of Polly Kitzinger

MedicAlert is a community of members, all of whom live with a wide range of health-related conditions ranging from heart conditions and epilepsy to rare conditions such as Diamond Blackfan Anaemia. We support all of our members, no matter what, through providing 24/7 emergency access to their medical records in emergencies, ensuring the most efficient, reliable and accessible route for medical professionals in times of need.

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