Understanding Advance Care Plan

Understanding Advance Care Plan

NAV TL;DR

If you don’t have time to read through the whole article, you can check out our short version below.

  • An Advance Care Plan (ACP) captures your preferences for your future health and personal care.
  • It is a care plan that you make in advance at no cost, exploring what you want or might not want in your medical care.
  • In the event of a serious medical emergency, your nominated healthcare spokesperson (NHS) can speak for you if you are unable to do so.

In uncertain times like these, no one knows what the future holds. You cannot predict what might become of your health. But you can plan ahead to make your wishes known.

If you become unconscious, not knowing where you are, who you are, or who you are with, how would you like your care to be? Would you prefer to be kept on a ventilator, or would you prefer that your loved ones let you go?

What is Advance Care Plan (ACP)?

An ACP is like a voice recorder that records your preferences for your future health and personal care. It preserves your voice in your medical care by allowing you to choose a nominated healthcare spokesperson (NHS). In the event of a serious medical emergency, your nominated healthcare spokesperson (NHS) can speak for you if you are not able to do so.

The ACP conversation gives you the chance to think ahead, and lets your loved ones know your wishes. It is a care plan that you make in advance, exploring what you want or might not want in your medical care. It reduces the stress faced by caregivers in deciding your care if you cannot do so.

Understanding Advance Care Plan

Most importantly, the decision-making power about your care preferences is placed into your hands based on your personal values and beliefs.

Why do an Advance Care Plan (ACP)?

Advance Care Planning (ACP) is the process of planning for your future health and personal care.

Firstly, having this conversation with your loved ones helps to explore how your values affect your healthcare preferences in difficult medical situations. For example, in the event of a coma, where you no longer know who you are, who you are with, or where you are, what would you like to do?

Understanding Advance Care Plan

Secondly, ACP reduces the possibility of high medical bills incurred from prolonging your life with life-sustaining treatment that you might not want.

More importantly, it gives you the chance to assign a loved one to be your voice if you become very ill one day. This is done by choosing a NHS, who will voice your preferences if you are not able to do so.

What will be covered in the ACP?

- Experiences with friends and family that have become seriously ill

- Concept of living well

- Choosing a nominated healthcare spokesperson

- Exploring goals for medical care during a serious injury, when your doctor believes that further aggressive treatment will not improve your condition and you are unable to know who you are, where you are and who you are with.

  • Comfort care?
  • Life-sustaining treatment?

- Your personal beliefs (cultural or religious)

  • Beliefs and values that might influence your preferences for care
  • Your wishes for funeral arrangements

Case study

Cecilia’s father, Mr Tan, had just been hospitalised. His doctors wanted to know what they would do next if things became worse. However, both Cecilia and her brother, Cale, did not know.

Fortunately, Mr Tan recovered. They were able to have an Advance Care Planning conversation with a trained facilitator. The facilitator explored what living well meant to Mr Tan, his care preferences, and how he would like to spend his last days.

In reflection, Cecilia shared: “No one wants to talk about the end. But from my experience, it really helped. I didn’t feel the burden that I was doing something wrong and I could care for my father the way he wanted.”

“From your conversations, you might find that what you thought your loved ones want is different from what they prefer. But at least you get to fulfil their wishes with peace of mind.”

What is the difference between an ACP and an Advance Medical Directive (AMD)?

Both ACP and AMD are made on a voluntary basis. An ACP covers a broader range of decisions related to your personal care and healthcare while an AMD only covers extraordinary life-sustaining treatment when death is imminent. It is a legal document that you sign in advance to inform the doctor treating you (in the event you become terminally ill and unconscious) that you do not want any extraordinary life-sustaining treatment to be used to prolong your life.

Also, an ACP involves a Nominated Healthcare Spokesperson, whereas an AMD can only be used when you are terminally ill, require life-sustaining treatment, and are unconscious or unable to exercise rational judgement.

What should you do?

There is no charge for completing the ACP. You can complete the ACP today with trained facilitators from government-appointed providers across Singapore. Examples include Life Point, SATA and polyclinics, and so on. You may also visit an ACP Community Node nearest to where you stay.

The ACP is the best thing you can do for your loved ones, in reducing the stress for them when making decisions about your care. More importantly, it is the best thing you can do for yourself, in deciding how you want to be cared for.

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