Dementia: Feelings based communication
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If you’re concerned about maintaining control over your future healthcare, creating a Living Will—also known as an Advance Decision—and an Advance Statement are important steps.
An Advance Decision is a legally binding document that outlines your medical preferences, ensuring your wishes are respected even if you become unable to make decisions or communicate them later in life. In contrast, an Advance Statement is not legally binding but allows you to express your personal wishes and care preferences. Together, these documents provide clarity for your friends, family, and healthcare providers, easing the burden of making difficult choices during challenging times.
Living wills – also known as Advance Decisions
If you’re worried about losing control of your care in future then you may want to make a Living Will.
A Living Will – also called an Advance Decision– is a legally binding document (In England, Wales and Northern Ireland – the law is different in Scotland) which sets out your instructions for your future healthcare.
Advance decisions allow you to ensure that your wishes are respected even if you become unable to make decisions or communicate your needs and preferences later in life.
They also help your friends and family to know your wishes, and can spare them from making difficult decisions at a hard time
These documents ensure that those providing your medical care are legally required to follow your wishes. They only come into effect once you have lost capacity.
The topics covered in a living will commonly include
- types of treatment you don’t want to receive
- when you want life-sustaining care to be withdrawn
- your preferences for active resuscitation in certain circumstances
Advance decisions are only valid if they meet certain conditions eg:
- Mental capacity – you must have capacity at the time of creating the advance decision.
- Over 18 – you must be an adult
- Clear specifications –you must explicitly outline the treatment(s) or care you and the various circumstances.
Living wills cannot be used to to demand or request anything that is illegal eg euthanasia or inappropriate eg denying pain relief
You can make a living will yourself although an expert solicitor can help you to think through the issues, and help with the wording to ensure the document will be legally binding. Ballpark costs are around £200.
Some charities can provide free support. This link can show you a free example form from the charity Compassion in Dying.
In an emergency – or at any other time – a living will can only be followed if everyone concerned knows about it. You could carry one around, put a note in your purse or wallet, use the message in a bottle scheme, or place a note in your keysafe.
Life is unpredictable and your circumstances and preferences can change over time so make sure you review your statement at regular intervals and make any necessary amendments.
Useful links:
Association of Lifetime Lawyers
Advanced statements
If you know some of the ways you would like to be treated and cared for in future, you could create an advanced statement.
This is not a legal document but it can help your family, doctors and carers understand and act upon your wishes if you can no longer advise them.
You can write an advance statement yourself, as long as you have the necessary mental capacity, and you can decide who sees it.
Your advance statement can include anything that you feel is important to you and might have a bearing on decisions about your care. Examples might include
- information about your identity
- any religious or spiritual beliefs
- dietary preferences, food sensitivites and allergies
- where you want to live and be cared for at the end of life
- things you enjoy
If you want to make sure your statement will be followed then you will need to tell key people about it and where they can find it. You can also make an appointment to discuss it with your GP and ask them to keep a copy in your medical notes.
It is not essential, but if you prefer, you can use a special form such as this one from the charity Compassion in Dying
You can also use an online form.
Life is full of twists and turns and your preferences can change over time so make sure you review and update your statement at regular intervals.
