What are my options?
It can be difficult to plan care into the future; who knows what any of us might need! But one way to stay in control, whatever happens, is to make sure that the care and medical attention that you receive is informed and, where possible, directed by you.
“It has taken me a long time to get on with it, I waited too long really, I should have done this years ago.”
Some of us already have a Lasting Power of Attorney (LPA). They authorise your nominated person(s) to speak on your behalf under law; it grants them the same power you have to say yes or no in your life now if you lose capacity to make your own decisions in the future. This is a particularly useful option for those of us that are worried about losing our faculties, or getting dementia.
There are two separate powers you can grant:
1. Power to make decisions about your property and financial affairs
2. The power to make decisions about your health and wellbeing.
You can appoint one or more people for each power, and within each power you can even direct exactly who can make decisions about what.
The forms are online via the Office of the Public Guardian, you can go to one of the charities offering help and advice, or you can contact your solicitor. However, it is very important that you register the form because only then can the Office of the Public Guardian grant your nominated person the ‘power’ to say yes or no on your behalf. It can take several months to do this, so if you wait to register it until something happens, you will not be covered until it comes through.
“It’s such a weight off my mind getting this sorted out. It wasn’t half as complicated as I thought! My daughter’s a solicitor but we didn’t even need to ask her questions, she was very impressed when we talked to her about what we’d done. Now my wife and daughter can tell the doctors what I’d want and I know that they won’t have to fight to be heard.”
Some people don’t want to ‘get legal’, and one easy way to record thoughts, feelings and wishes for the future is to make an Advanced Statement – it’s not legally binding like an LPA, but it gives loved ones and professionals a very clear idea about what you want. It’s a place to say what is important to you and set down some of your values; whether you’d prefer to be in care or at home, whether there are any faith practices that are important to you, some of your likes and dislikes, the way that you live your life and what kind of person you are. In the event that you lose capacity, an Advanced Statement must be taken into account in every decision made about your future care, so it can be really powerful.
“I like the idea of having my words spoken out loud when my dementia takes over – I might even record me reading it so they can hear exactly who I am, ‘cause even then I’ll still be me won’t I?”
It’s harder to be more specific about the future when you don’t really know what it holds. However, if you’re already ill or have a good idea about the kinds of things that are likely to come up, you can also make provision for that too.
An Advanced Decision to Refuse Treatment (ADRT) sets out the specific treatment for which you refuse consent in the future. Everyone is different, for some of us we know that there are some treatments that we absolutely do not want – mechanical breathing apparatus, resuscitation, or feeding tubes are things that often come up. An ADRT provides a legal document that all health professionals have to abide by, even if you can’t tell them at the time. If you make one of these and the professional knows about it but ignores it they can be struck off and prosecuted for assault. If this sounds like something you’d want, make an appointment to talk to your GP about it – tell the receptionist so they can make sure you have enough time.
If there are things that are likely to happen in the course of an illness, you and your GP can write an Emergency Health Care Plan so that your carer, Cumbria Health On Call (CHOC) and the emergency services can have this guidance document about what you want them to do.