Planning for Deterioration: A Beginner-Friendly Start
Planning for Deterioration: the few things that matter most, and the mistakes that catch people out early.
Deciding in advance what should happen if a condition worsens.
Key takeaways
- Advance decision to refuse treatment: legally binding in England and Wales if valid and applicable
- Advance statement: records preferences; not legally binding
- Most useful single change: Discuss wishes with family and your clinical team, not only on paper.
- Commonest mistake: Assuming a spouse can automatically decide for you.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Why bother
Decisions get made either way, and planning is the only way they are made by the person they concern.
Start here
Two things, and nothing else until both feel routine.
- Discuss wishes with family and your clinical team, not only on paper
- Set up lasting power of attorney while capacity is clear
Then add these
After that, these.
- Keep documents accessible and tell people where they are
The numbers, in one place
| Measure | Figure |
|---|---|
| Advance decision to refuse treatment | legally binding in England and Wales if valid and applicable |
| Advance statement | records preferences; not legally binding |
| Lasting power of attorney | health and welfare, and property and finances, separately |
| ReSPECT | a process recording recommendations for emergency care |
Common early mistakes
- Assuming a spouse can automatically decide for you
- Leaving it until capacity is in doubt
Where to go next
- Myths About Planning for Deterioration, Checked Against the Guidance
- Answers to the Common Questions on Planning for Deterioration
- Planning for Deterioration — the reference entry
- What the Guidance Really Says About Living with Multiple Conditions
- Self-Management: What Published Guidance Supports
When to speak to a doctor
Speak to your GP about advance care planning, particularly after a significant diagnosis or hospital admission. An advance decision must meet specific legal requirements to be valid — take advice rather than relying on a written note.
Where this comes from
- NHS — Advance decision to refuse treatment
- Resuscitation Council UK — ReSPECT
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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