Planning Ahead: What the Evidence Actually Says
Decisions get made either way, and recording your wishes is the only way they are made by you.
Key takeaways
- Lasting power of attorney: covers health and welfare, and property and finances, separately
- Advance decision to refuse treatment: legally binding in England and Wales if valid and applicable
- Most useful single change: Set up lasting power of attorney while you clearly have capacity.
- Commonest mistake: Assuming a spouse can automatically make decisions for you.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What it is
Recording your wishes for care and decision-making while you are able to. It sits within Healthy Ageing. The table below gives the figures guidance actually works from.
The numbers, in one place
| Measure | Figure |
|---|---|
| Lasting power of attorney | covers health and welfare, and property and finances, separately |
| Advance decision to refuse treatment | legally binding in England and Wales if valid and applicable |
| Advance statement | records preferences; not legally binding |
| Mental Capacity Act 2005 | the legal framework in England and Wales |
What helps
These are worth doing. None of them needs to happen all at once.
- Set up lasting power of attorney while you clearly have capacity
- Discuss your wishes with family and your GP, not only on paper
- Keep copies accessible and tell people where they are
- Review documents periodically as circumstances change
What to avoid
The usual wrong turns. Some are more tempting than others.
- Assuming a spouse can automatically make decisions for you
- Leaving it until capacity is in doubt
- Recording wishes without telling anyone they exist
Where to go next
- The First Steps With Planning Ahead
- Answers to the Common Questions on Planning Ahead
- Planning Ahead — the reference entry
- Strength and Balance in Later Life: What Published Guidance Supports
- Polypharmacy: Sorting the Evidence From the Noise
When to speak to a doctor
Speak to your GP about advance care planning, particularly after a significant diagnosis. An advance decision to refuse treatment must meet specific legal requirements to be valid — take advice. If you are worried about someone's capacity to make decisions, discuss it with their GP.
Where this comes from
- NHS — Advance decision to refuse treatment
- Office of the Public Guardian — lasting power of attorney
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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