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Advance decisions (living wills)

When you're ill, you can usually discuss treatment options with your doctor and then jointly reach a decision about your future care. However, you may be admitted to hospital when unconscious or not in a position to make some of your own decisions about your treatment. Under these circumstances, doctors and nurses will talk to your family and friends in order to decide what treatment is in your best interests.

If you are concerned about this happening to you, and have strong feelings about the type of treatment you do not wish to receive, it might be a good idea to consider making an advance decision (often known as a living will or advance directive).

An advance decision is a legally-binding decision to refuse specific medical treatment if you are not able to make a decision at the time when it is required. This may sometimes be the case if, for example, you have dementia or a learning disability, or are unconscious or unable to communicate. Your advance decision can state that you won't accept medical treatment such as a blood transfusion or organ transplant, or that you don't want to be fed through a tube if you aren't able to swallow.

You can also make a written statement about the sort of care you would like to receive, which can include information about dietary preferences, or religious or cultural arrangements for your end of life care. Unlike advance decisions, written statements aren't legally binding, but health and social care workers should take them into account when planning your care.

An advance decision or a written statement can be made by anyone who can make an informed choice to do so.

Talk to your close relatives and friends, and / or health and social care professionals  about the sort of medical treatment and care which you would or would not want to receive, and under which circumstances. If you don't have an advance decision and you are unable to decide about what is being offered, then doctors and nurses will ask your immediate family or friends about your wishes, so it's a good idea to make sure they know what you would want.

In most situations an advance decision does not need to be in writing, but putting it in writing should ensure that medical staff will be made aware of it if required.

But if an advance decision is about life-sustaining treatment it has to be in writing and include a statement that the decision applies even when your life is at risk, and be signed and witnessed.

If you make an advance decision, you should let your immediate family know about it, and also let your doctor know so that it will appear on your medical records if you need urgent treatment. 

The Independent Age website provides a guide called Managing my affairs if I become ill which includes information on Advance Decisions

Age UK has a helpful factsheet on advance decisions and written statements, which explains what you need to do and how health and social care workers should treat an advance decision or written statement.

Compassion in Dying has downloadable advance decision forms and information to help you. 

The Which website offers advice on all aspects of looking after someone's affairs.