Advance care planning: concise evidence-based guidelines

Abstract

At the core of current health and social care are efforts to promote patient-centred care, offer choice and offer the right to consent to or refuse treatment and care offered. This can be difficult to achieve when an individual has lost capacity – the ability to make one's own, informed decision. Advance care planning (ACP) may help in such scenarios. Advance care planning has been defined as a process of discussion between an individual, their care providers, and often those close to them, about future care. The discussion may lead to: an advance statement (a statement of wishes and preferences) an advance decision to refuse treatment (ADRT – a specific refusal of treatment(s) in a predefined potential future situation) the appointment of a personal welfare Lasting Power of Attorney (LPA). All or any of these can help inform care providers should the individual lose capacity. In writing these guidelines, we have assumed that readers are familiar with making valid clinical decisions according to the Mental Capacity Act (MCA) 2005.