3.1 Describe factors an individual may consider when creating their advance care plan

This guide will help you answer 3.1 Describe factors an individual may consider when creating their advance care plan.

Advance care planning is the process where a person thinks about and records their wishes for their future health and social care. It can cover medical treatments they would want or not want, where they would prefer to live, and who they trust to make decisions for them if they cannot speak for themselves. The plan can give clear instructions to family, carers, and medical staff.

Every individual creates their plan in their own way. The choices will be shaped by their personal values, health condition, and what matters to them in daily life. It can give peace of mind and help avoid confusion in difficult times.

Personal Values and Beliefs

Personal values shape how people make decisions about their care. These can come from culture, religion, ethics, or life experiences. For some, protecting dignity at the end of life is the most important thing. For others, extending life for as long as possible is the main goal.

A person may think about:

• Their religious or spiritual beliefs
• Traditions that guide decision-making
• Personal moral views about life and death
• Beliefs about the use of life-support treatments

These beliefs can affect decisions about resuscitation, pain relief, and medical interventions.

Current Health and Prognosis

An individual’s current health is a key factor in their planning. A person with a long-term illness may focus on comfort and pain management. Someone recently diagnosed with a life-limiting condition may think ahead to how their needs will change.

Factors to think about may include:

• Current diagnosis and treatment options
• Likely progression of the condition
• Physical abilities now and possible changes
• Risks from certain treatments
• Likelihood of recovery from medical procedures

Understanding how a health condition might develop helps the person choose care that matches their wishes.

Quality of Life

Quality of life means different things to different people. Some value independence and the ability to do daily tasks without help. Others are content with limited independence as long as they can spend time with loved ones.

Questions to guide thinking include:

• What activities make life enjoyable?
• How much independence is needed to feel content?
• Is being able to communicate with others important?
• Would living with pain or discomfort be acceptable if life was extended?

Defining quality of life helps guide decisions on treatments and care settings.

Preferences for Care Settings

Where a person receives care can be just as important as the type of care. Some prefer to stay at home for as long as possible. Others may choose a hospice, nursing home, or hospital depending on the support and services available.

Choosing a setting depends on:

• Access to specialist care
• Availability of family support
• Comfort and familiarity of surroundings
• Safety and accessibility of the environment

Recording these preferences in the advance care plan helps them be respected.

Medical Treatments and Interventions

Advance care planning may involve decisions about specific treatments. A person may accept some treatments but refuse others.

Considerations include:

• Do-not-attempt-resuscitation (DNAR) decisions
• Use of ventilators or feeding tubes
• Use of antibiotics for certain infections
• Blood transfusions or surgery near end of life
• Pain relief methods

Recording these choices in writing guides medical staff if the person cannot speak for themselves.

Appointing a Decision-Maker

Sometimes a person will choose someone they trust to make decisions for them in the future. This is known as appointing a lasting power of attorney for health and welfare. This can give peace of mind that decisions will match their wishes.

When appointing a decision-maker, the individual may think about:

• Who understands their values and beliefs
• Who can cope with difficult decisions under pressure
• Who can communicate clearly with healthcare staff
• Whether that person is willing to take on the role

The chosen person should be involved in the planning discussions.

Legal and Ethical Considerations

An advance care plan should comply with UK laws. This includes the Mental Capacity Act 2005. This law says that people have the right to make their own decisions while they have capacity. If they lose capacity, decisions must follow their known wishes, values, and best interests.

Things to think about:

• The plan should be in writing and signed
• It should clearly state wishes and any refusals of treatment
• It must be accessible to health professionals when needed
• Witnessing may be required for some legal documents

Following legal requirements makes the plan stronger and easier to follow.

Communication with Family and Professionals

Sharing the plan with family, friends, and professionals is important. This can reduce conflict and confusion later. It also supports informed decision-making.

Steps include:

• Discussing wishes openly with close family
• Giving copies of the plan to the GP, hospital team, and care staff
• Keeping a copy with personal documents at home
• Updating people if the plan changes

Clear communication means everyone knows what is wanted before a crisis.

Cultural Considerations

Cultural background can influence care preferences. Traditions can shape ideas about death, dying, and family involvement. For example, some cultures expect family members to make decisions collectively. Others see decisions as a personal choice.

When creating a plan, a person may think about:

• Cultural beliefs around medical treatments
• Rituals and practices for end-of-life care
• The role of family and community in decision-making
• Language needs for communication

Cultural preferences should be written clearly so they are respected.

Emotional Readiness

Some people may be ready to talk about end-of-life care early in their illness. Others may find it difficult and need time. Emotional readiness can affect how quickly and in how much detail a plan is created.

A person may consider:

• How comfortable they feel discussing death and care preferences
• Whether they want support from a counsellor or religious leader
• If family members are ready to hear and accept their wishes

Taking time can improve the quality of the plan.

Financial Considerations

Finances can influence where and how care is provided. Some care options may need private funding, while others are offered through the NHS or local authority.

Key points may include:

• Cost of private nursing care at home
• Costs linked to care home placements
• Travel expenses for receiving treatment
• Impact on family finances if they provide care

Being clear about financial choices can help make the plan more realistic.

Reviewing and Updating the Plan

An advance care plan is not fixed forever. It should be reviewed regularly, especially if health or personal circumstances change. A treatment that seemed right last year might not feel right now.

Reasons to review:

• New diagnosis or change in health
• Change in family situation or carers
• New treatments becoming available
• Change in personal priorities

Keeping it up to date makes it more accurate and useful.

Respecting Privacy and Confidentiality

The details of an advance care plan are personal. Access should be controlled and only shared with people who need to know. This protects the individual’s privacy and trust in the system.

Steps may include:

• Storing the plan securely at home and in care settings
• Only giving copies to trusted individuals and professionals
• Following data protection laws when sharing information

Privacy builds trust between the person, family, and care staff.

Final Thoughts

Creating an advance care plan is a deeply personal process. Each decision is shaped by the person’s own life, health, values, and hopes for the future. By thinking about these factors in advance, they give themselves a stronger voice in their care, even if they cannot speak for themselves later.

Giving time and thought to the plan can protect dignity and support wellbeing. It can help families feel more confident that they are honouring the wishes of their loved one. Good communication, clear records, and respect for individual choice can make advance care planning a positive and empowering part of health and social care.