MCA resources on Advance decision

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Starting the conversation: planning ahead for your treatment and care

Compassion In Dying

This booklet supports individuals to talk about their wishes for care and treatment with their family, friends and doctor.

Last updated on hub: 09 September 2020

Making and implementing advance decisions: a toolkit for healthcare professionals

Compassion In Dying

This toolkit supports healthcare professionals’ understanding of advance decisions. It looks at: the legal framework for advance decisions and explains healthcare professionals’ obligations when caring for someone who lacks capacity; what an advance decision is and the criteria one needs to meet; how to support someone to make an advance decision; what steps should be followed if a person lacks capacity and has an advance decision; challenges that healthcare professionals may face when acting on an advance decision and offers practical guidance to help overcome them; and the relationship between advance decisions and lasting power of attorney for health and welfare. It consolidates guidance from the Mental Capacity Act, General Medical Council and British Medical Association.

Last updated on hub: 09 September 2020

Advance decisions (living wills): an introduction

Compassion In Dying

This factsheet explains what an advance decision is, what it can and cannot be used for, and how to make one.

Last updated on hub: 09 September 2020

Advance decision pack

Compassion In Dying

This document contains the advance decision to refuse treatment form – the form sets out the situations in which individuals want to refuse medical treatment if they are unable to make or communicate that decision in the future; and guidance notes – this gives information to help people complete the form. The notes explain when an advance decision would be used and offers support to consider the wishes.

Last updated on hub: 09 September 2020

Planning ahead: my treatment and care

Compassion In Dying

This practical guide includes information to understand how treatment and care decisions are made, how individuals can plan ahead to ensure they stay in control of these decisions, and who to talk to and share their wishes with.

Last updated on hub: 09 September 2020

My decisions

Compassion In Dying

A free tool to support people to draft an advance decision or advance statement online.

Last updated on hub: 09 September 2020

Management of patients with an advance decision and suicidal behaviour: a systematic review

Background: The use of advance care planning and advance decisions for psychiatric care is growing. However, there is limited guidance on clinical management when a patient presents with suicidal behaviour and an advance decision and no systematic reviews of the extant literature. Objectives: To synthesise existing literature on the management of advance decisions and suicidal behaviour. Design: A systematic search of seven bibliographic databases was conducted to identify studies relating to advance decisions and suicidal behaviour. Studies on terminal illness or end-of-life care were excluded to focus on the use of advance decisions in the context of suicidal behaviour. A textual synthesis of data was conducted, and themes were identified by using an adapted thematic framework analysis approach. Results: Overall 634 articles were identified, of which 35 were retained for full text screening. Fifteen relevant articles were identified following screening. Those articles pertained to actual clinical cases or fictional scenarios. Clinical practice and rationale for management decisions varied. Five themes were identified: (1) tension between patient autonomy and protecting a vulnerable person, (2) appropriateness of advance decisions for suicidal behaviour, (3) uncertainty about the application of legislation, (4) the length of time needed to consider all the evidence versus rapid decision-making for treatment and (5) importance of seeking support and sharing decision-making. Conclusions: Advance decisions present particular challenges for clinicians when associated with suicidal behaviour. Recommendations for practice and supervision for clinicians may help to reduce the variation in clinical practice.

Last updated on hub: 08 September 2020

Advance decision to refuse treatment – also known as a ‘Living Will’: frequently asked questions

NHS North Central London Clinical Commissioning Group

Key information on advance decision to refuse treatment, including the role of doctors, how to ensure an advance decision is valid and the effect of it if you lose your capacity temporarily.

Last updated on hub: 08 September 2020

Advance decision to refuse treatment: patient information leaflet

NHS North Central London Clinical Commissioning Group

Statement form for advance decision to refuse treatment (A5). An advance decision allows a person over the age of 18 to refuse a specific treatment in the future when they lack the capacity to consent to, or refuse, that treatment.

Last updated on hub: 08 September 2020

Preferred priorities for care: patient information leaflet

NHS North Central London Clinical Commissioning Group

A preferred priorities for care (PPC) statement form (A4), which patients can fill in to state their wishes and care preferences are for the last few months or year of their life.

Last updated on hub: 08 September 2020

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