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Dying Well: Thinking Ahead

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Planning ahead is important to reduce the risk of a crisis occurring in the last weeks and days of life and to enable everyone providing care to understand and support the preferences and priorities of the person who is dying.

Planning ahead can include consideration of:

  • an awareness of any diagnosis and the implications
  • fears and how they could be avoided
  • any goals and compromises
  • resuscitation and treatment decisions
  • preferred place of care
  • spirituality requirements

Advance care planning is important, for everyone: it would be useful to consider the last weeks and days of our lives in the way that we consider and plan birthdays and weddings, anniversaries and births. It would be sensible for everyone to consider completing a Thinking Ahead form when they reach 50 years old, or develop cancer or a Long Term Condition such as diabetes or heart disease.

Advance care planning is a priority, for those with:

  • General frailty and co-existing conditions that means death is expected within the next 12months
  • Existing conditions if there is a risk of dying from a sudden acute crisis in the condition

  • Advance care planning should be considered urgently,
    if not already in place, for all those with advanced, progressive, incurable illness to live as well as possible until they die. Patients are approaching the end of their lives when they are likely to die within the next 12 months. This includes patients whose death is imminent (expected within a few hours or days) and also those who have life threatening acute conditions caused by sudden catastrophic events.

    Frequently asked questions

    Why should I think ahead?

    Thinking ahead allows everyone involved to plan ahead. This is important to reduce the risk of a crisis occurring in the last weeks and days of life. It also means everyone providing care is able to understand and support the preferences and priorities of the person who is dying.

    It often takes time to arrange and put in place the equipment, medication and care etc that is required to support a comfortable death: thinking ahead and planning ahead provides the time for these to be prepared.

    What do I need to think ahead about?

    Power Of Attorney: who would you like to take care of your wealth and healthcare decisions when you no longer feel able to or are unable to?
    Preferred place of care: where would you prefer to be in the last weeks and days and hours of your your life?
    When your condition means that CPR would not be likely to be effective, would you like a DNAR certificate to prevent anyone trying to resuscitate you if your heart stops beating?
    Consider the Thinking Ahead document on this page to write down your preferences and share this with your family or friends and ask your General Practitioner to scan and up to date copy into your medical records.
    Consider asking your General Practitioner to add Additional Information to your Summary Care Record: you simply need to provide your verbal consent for this or a relative acting on your behalf must provide written consent. Clinicians in other organisations such as paramedics and consultants and District Nurses can then access this information if you agree......

    Who is Martha?

    Our donkey logo was created to help with the recognition of our end of life and palliative care resources and services.

    The donkey is used in agriculture to protect other animals from predators and is a symbol of humility and peace; they are kind natured, gentle and intelligent.

    The logo was created by a donkey lover as a sketch from a photograph of Martha, (also known as Minty) who lives in Wales.

    Next review due: 1 September 2020