Advance Planning

We usually have the right to decide what treatment we do and do not want to receive (subject to availability) within the healthcare system.

Sometimes people become very unwell and are judged to have lost ‘capacity’ to make decisions and this right is taken away. This can be very frightening and upsetting. If your relative or friend is worried about this happening, then you might want to help them with Advance Planning.

Advance Planning (also known as Advance Directives or Advance Decision-making) ensures the wishes of an individual are clearly recorded when they are well and do have capacity. These can then be taken into account if they become unwell and loose capacity. This is important for people with psychosis or bipolar disorder where capacity can fluctuate widely.

Advance Planning can be very helpful for people who have previously had negative experiences with particular drugs or treatments. It can reduce anxiety about becoming ill in the future by increasing a sense of control over what might happen.

Click HERE to download a helpful guide about Advance Planning and how to do it.

Advance Planning can involve drawing up any of the following:

Advance Decision to Refuse Treatment (ADRT)

This is a legally binding statement that ensures treatment they have refused cannot be given to them. It can only be overridden if they are sectioned under the Mental Health Act. It must be written down and signed by the individual and another adult. It then needs to be shared with the medical team.

Advance Statement (or Statement of Wishes and Feelings)

Outlines their wishes about what they would like to happen if they lose capacity. It can include, but is not limited to:

• medical treatments, e.g. preferred medication and any which cause allergic reactions
• basic care, e.g. activities that calm or when to be left alone or in a quiet space
• personal issues, e.g. who to inform, domestic concerns such as pet care
• finances, e.g. bills to pay

This needs to be in writing and shared with people who need to know and on mental health records.Unlike ADRT (see above) Advance Statements are not legally binding documents.

Lasting Power of Attorney (LPA)

This appoints a person of their choice (often relative/close friend) to take control of their legal affairs if they lose capacity. There are two types of LPA; one for managing personal welfare issues and one for property and financial affairs. LPAs have to be registered with The Public Guardian www.justice.gov.uk/about/opg and it costs a fee to do so.