1. Why plan ahead?
If you have , planning how you want to be cared for in future can:
- Help you get the care you want
- Make sure loved ones and healthcare professionals know your preferences
- Help you feel more settled, safe and in control
Making choices or decisions about the end of life is not easy. And there’s no right or wrong time to think about these things.
Our list of questions to think about might help you start planning ahead.
2. How and where you want to be cared for
Many people worry about becoming dependent on others as they become more ill. It can be painful to look ahead to this time, but it may be helpful to think about where and how you want to be cared for.
Some people want to remain at home so think about what changes they might need to make for this to happen. They may find everyday tasks more difficult. For example, if they can’t manage stairs, they might be able to sleep in a room downstairs instead.
You can talk to your GP, palliative care team or district nurse about any equipment or care you might need to allow you to stay at home. Social services can assess your needs (and those of your carer or carers) and can advise you on what local services could be helpful to you. Some services may need to be paid for.
An occupational therapist can also assess what equipment and alterations may be helpful at home. Your treatment team, palliative care team or GP can refer you to an occupational therapist.
Some people choose to be cared for in a hospice or nursing home in the last few weeks or days of their life and may familiarise themselves and their family with the surroundings and staff.
If you feel you’ll need support at a later date, you can talk to your GP about making contact with services that are available to help in your area. This way, when you and your family need them, you’re not dealing with strangers. This might include local community palliative care and district nursing services.
You can change your mind about any of your decisions at any time.
Your preferences about treatment and care
Usually, you will talk with your GP and treatment team about any treatments you don’t wish to have. This can include treatment that may be given towards the end of life to prolong it.
If possible, it’s good to have an honest and open discussion with your partner, relatives or closest friends in advance, so that they fully understand your choices.
Advance care planning
Advance care planning can include anything about your future care.
It can be helpful to write down your choices in advance so that if you become unable to discuss things or make decisions, the doctors will still know what your wishes are. It can also let your family and friends know what you want.
Marie Curie, Compassion in Dying and Advance Care Plan have useful resources to help with this.
Advance statement
An advance statement is a written general statement about your views and wishes. It’s not legally binding, but your doctors and nurses should take it into account when caring for you.
Advance decision
An advance decision allows you to write down that you want to refuse certain treatment. In England and Wales, an advance decision is legally binding. In Scotland and Northern Ireland, it isn’t legally binding but must be taken into account by the medical team. In Scotland, an advance decision is also known as an advance directive.
Lasting power of attorney (LPA)
A lasting power of attorney (LPA) is a legal document valid in England and Wales. An LPA is when you legally appoint someone you trust to make decisions about your property and financial affairs, and/or your health and welfare at a time in the future when you can no longer do so.
The process is different in Scotland and Northern Ireland.
Treatment Escalation Plan
A Treatment Escalation Plan (TEP) provides another opportunity for you and the healthcare professionals looking after you, to discuss and come to an agreement on your plan of care. The TEP details the treatment options you may or may not benefit from should your health condition get worse (deteriorate).
You may decide that there are particular treatments you do not wish to receive.
3. Putting your affairs in order
Writing a will
Making a will is a thoughtful and effective way of taking care of the people you love, as it can spare them the difficult decisions and financial problems that can happen if you don’t make your wishes clear.
When writing a will or amending an existing one, it’s usually best to use a solicitor.
Citizens Advice, Which?, GOV.UK and The Law Society have more information on how to write a will and where to find a solicitor.
Letters or memory boxes for children
Some people write letters to their children, particularly if they’re very young, or put together memory boxes containing messages or things that have a special meaning. These can be very precious to a child whose parent has died.
Macmillan Cancer Support and Winston’s Wish have more information on making memory boxes.
Planning a funeral
Some people choose to plan their own funeral. This may be a difficult thing to do, but it can be part of how someone comes to terms with the fact that they’re approaching the end of life. It can also be reassuring to know that things have been organised for your loved ones and that they know what your wishes are.
GOV.UK has information on arranging a funeral.
4. Bereavement support for your family
Palliative care teams can often provide bereavement support to families of people who have been in their care, including children and young people.
GPs can also refer people for bereavement counselling, even if someone died a long time ago.
You can also find support, advice and information from Cruse Bereavement Support.
Financial support
Bereavement Support Payment provides accessible financial help for spouses and civil partners in the difficult period after a family death. It is available to people of any age up to state pension age. It is not taxed.
Claims need to be made within 3 months to receive the full amount.
5. Questions to help you plan ahead
The following questions may help you start to think about planning ahead.
- What information do you need about your illness and what may happen to you?
- Where would you prefer to be cared for towards the end of your life (for example at home, in a hospice, hospital or nursing home)?
- Do you want to write an advance decision to refuse treatment or resuscitation?
- Do you wish to arrange lasting power of attorney?
- Have you made or updated your will?
- Are there any spiritual or religious practices that you wish to be carried out before or at the time of your death, or after you have died? Who do you need to ask to make sure this happens?
- What funeral arrangements would you like to be made? Do you need to speak with anyone to do this?
- Who do you want to make the arrangements? Do you wish to plan anything yourself or with your loved ones?
- Do you want to be cremated or buried?
- Do those looking after your affairs know where to find all the necessary documents?
- Is there anything that you want done for the people that you love?
- Do you wish to leave letters, messages, memory boxes or recordings for loved ones?
