Advance care planning (ACP) is a process that involves thinking and discussing your values, goals and preference for medical care, and making decisions about the type of care you would want in the event that you are unable to make those decisions for yourself.

ACP involves discussions with family, friends, and healthcare providers, and may involve the creation of legal documents, such as a living will (Advance Medical Directive) or lasting power of attorney. Discussing end-of-life issues with your loved ones can often be an uncomfortable topic. However, starting these conversations can help ensure you receive the type of medical care you want, even when you are unable to communicate your wishes. This can be especially important for individuals who have a chronic condition or who are nearing the end of their life.

Through ACP, you can take control of your own healthcare decisions and indicate your wishes. Healthcare providers can also provide care that aligns with those wishes, and reduce the burden on family members who may be having difficulty making medical decisions on your behalf.

Despite the benefits of ACP, there are still misconceptions that can prevent some from engaging in the process. Let us address some of the common misconceptions and the facts that debunk them.

Is ACP only for older adults, people with critical illness or who are dying?

ACP is for everyone and is not just about end-of-life care. Accidents and sudden illnesses can happen at any time, and having a plan in place can ensure that a person’s wishes are honoured. ACP includes decisions about medical treatment preference, pain management, comfort care, and any other aspects of care that can improve quality of life.

Does ACP mean giving up control of medical decisions?

On the contrary, ACP gives you more control over your medical care. By expressing your wishes in advance, you can ensure that your loved ones and healthcare providers know what you want, even when you are unable to communicate your wishes later on.

Is there a need for ACP if you have done your Lasting Power of Attorney (LPA) or Advance Medical Directive (AMD)?

A LPA is a legal document that officially appoints someone to make decisions and act on your behalf when you lose mental capacity one day. On the other hand, an AMD is a legal advance directive stating your preference for life-sustaining treatment.

While both LPA and AMD are legally binding documents that state specific instructions, ACP is a broader process that can provide additional guidance and clarity. It includes ongoing communications with loved ones and healthcare providers and helps ensure that your wishes are fully understood and respected, and avoid unnecessary medical interventions.

Is ACP a one-time event?

ACP is an ongoing process that should be revisited regularly to ensure your wishes are up-to-date and reflective of your current values and goals. ACP conversations can also involve updating legal documents and sharing new information with loved ones and healthcare providers. Generally, ACP is a reflection of your perspectives and preferences towards life. As your life changes, so may your life goals and decisions. You may continuously make changes to your ACP as long as you have the mental capacity to do so.

Never too late to start planning – the earlier, the better

Nobody knows when a medical emergency can happen. Starting early allows you to make informed decisions about your healthcare while you are still able to do so. The earlier you plan for your advance care, the more time you have to think about and communicate your wishes to your loved ones and healthcare providers. Early planning can also alleviate stress and uncertainty for your loved ones, and even prepare them emotionally, especially for the end-of-life process. Anyone can start ACP with three simple steps:

  1. Reflect on what you want – think about what matters to you, and what kind of medical care aligns with your values and preferences. You may want to consider factors such as your quality of life, pain management, spiritual beliefs, and cultural traditions.

  2. Choose your nominated healthcare spokesperson – think about the people you trust and choose the person you can entrust with making medical decisions on your behalf when you are unable to.

  3. Make a record of your choices – make an appointment with an ACP facilitator to record your preferences.

ACP can be done at government hospitals, polyclinics and social care providers. At NHCS, you may approach our ACP team at 6704 8966/67.

This article is from Murmurs Issue 44 (September – December 2022). Click here to read other articles or issues.