1. Advance Directives/Living Wills

2. Definition Statement made by a mentally competent adult, that gives instructions about how they would wish to be treated in the event of any future loss of mental capacity It made be seen as a method of extending a patients autonomy by allowing them to make decisions which they would otherwise be excluded from.

3. What information is needed No set format Ideally witnessed by Dr or Lawyer Should include –Full details including any diagnoses –Clear statement of treatment to be refused –Circumstances in which the decision applies –Date you wrote or reviewed document –Signature –Ensure family/friends/docs are aware –Get a witness to co-sign –Include refusal for treatment if life is endangered

4. Valid if… Author has capacity, >18, not under duress Fully informed of nature and consequences of AD Situation to which AD applies are clearly stated and now apply Not been amended or revoked Author now lacks capacity AD refuses certain treatments or specifies the level of deterioration at which active treatment should cease

5. Where can I get one www.advancedstatement.co.uk http://www.barnsley.gov.uk/advanced- statement-advanced-decisionhttp://www.barnsley.gov.uk/advanced- statement-advanced-decision For Barnsley can call 01226 770023

6. What to do if given an AD Make sure it is the correct pt and they were over 18 at time of writing Examine them and assess capacity Must not have capacity for AD to come in to effect Ask for 2 nd opinion Contact any witnesses if possible (to check capacity at time of writing) Contact nominated proxy (no legal rights) Check current situation is specified in AD Carefully document all decisions

7. Future care planning Preferred Priorities for Care www.endoflifecareforadults.nhs.uk/.../pref erredprioritiesforcare