Why plan ahead at all?
None of us likes to imagine being seriously ill. But there may come a time - through illness, accident or simply age - when decisions about your care have to be made and you can't take part in making them.
When that happens, two things are true. Doctors will do their best with the information they have. And the people who love you will be asked what you would have wanted - at the hardest possible moment to be answering questions.
Planning ahead changes both. It makes it far more likely you receive the care you would have chosen, and it lifts a heavy weight from your family: instead of deciding for you, they're speaking for you.
The formal documents - and what they do
In the UK there are a small number of formal tools for planning ahead, and it's worth knowing their names:
- An advance statement - a written record of your wishes and preferences about your care: where you'd like to be cared for, what matters to you day to day.
- An advance decision to refuse treatment - a legal document setting out specific treatments you would not want.
- Lasting power of attorney - a legal appointment of someone you trust to make decisions on your behalf if you can't, for health and welfare, finances, or both.
- DNACPR and ReSPECT forms - clinical documents recording decisions about resuscitation and emergency care, agreed with your healthcare team.
The NHS guide to planning ahead explains each of these properly, and your GP can help you put the formal pieces in place.
One thing matters alongside all of them: the paperwork only works if the right people know it exists, know where it is, and understand the thinking behind it. That's the part most plans miss.
What to record, in your own words
Beyond the formal documents, there's a set of things your family and carers would dearly want to know:
- Who speaks for you - the person you'd trust with healthcare decisions, and where any power of attorney or advance decision is stored.
- What care means to you - home, hospice or hospital; the personal preferences around food, faith, comfort and visitors that make care feel like yours.
- Your lines - treatments you would or wouldn't want, and whether a resuscitation decision exists and where it's kept.
- The practical anchors - your GP, your medications, your conditions and allergies: the details that keep your care safe when you can't recite them.
Five questions to get you started
- Who should make healthcare decisions for you if you are unable to?
- Where would you prefer to receive care if seriously ill, and are there any personal care preferences?
- Are there treatments you would or would not want?
- Do you have a Do Not Resuscitate (DNR) order in place?
- Who is your GP or main healthcare provider, and is there a preferred hospital?
These questions come from the Health & Medical Wishes chapter of the Afterwords book "Health and funeral plans. Your life and wishes".
Where your answers fit alongside the paperwork
To be clear: recording your wishes in Afterwords doesn't replace the legal documents - an advance decision or power of attorney has to be made properly to carry legal weight.
What Afterwords does is hold everything the paperwork can't: your wishes in your own words, the reasons behind them, and - crucially - where the formal documents are kept. You choose exactly who can see your answers and when, so the people who'd need them aren't searching through drawers on the worst day to be searching.
Start gently
You don't have to face all of this in one sitting, and you don't need every answer today. "I haven't decided yet" is worth recording too - it tells your family you thought about it.
Pick the easiest question first - most people start with who they'd trust to speak for them. The rest can follow at whatever pace feels right.