Having the BIG Conversation
Advanced Care Planning

Advanced Care Plans

There is one statistic that cannot be challenged - 100% of people will die one day, it is a universal part of life’s journey.  It is also still too often taboo to discuss the ‘D’ word, but the reality is that talking about it will not make it happen tomorrow, just as not talking about it will not make it go away.   Most of us are familiar with the concept of making a Will to deal with our financial affairs, but fewer people are aware of Advance Care Plans. Putting an Advance Care Plan in place can be an important step towards making sure that, at the appropriate time, the care, support, and medical treatment you receive reflects your wishes.  The process of talking more openly about dying, and discussing what you want in your plan can itself be therapeutic and help you to make the most of life and better support those close to you. After all, we only get one chance to get it right

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Q. Why is it important to have an Advance Care Plan?

A. Research conducted last year for the Dying Matters Awareness Week* showed that 71% of the public agree that if people in Britain felt more comfortable discussing dying, death, and bereavement, it would be easier to have our end-of-life wishes met. However, only 18% say they have asked a family member about those wishes.

Q. What is ‘The Big Conversation’?

A. It’s about sharing with family members and others close to you, as well as medical professionals such as your GP, your wishes and preferences for when you approach the end of life. This allows you to have control over the care and treatment you receive whether it’s today, or in the future.

Q. When should I have The Big Conversation?

A. Losing the ability to make decisions for yourself can happen unexpectedly and thinking about your wishes can take time, so it’s best to begin as early as possible. Do it before it’s too late as we never know what’s around the corner.

Q. What’s the best way to prepare for The Big Conversation?

Perhaps start by gently letting someone know what you want to talk about a few days or weeks ahead, as this will help them prepare for the conversation. It may be helpful to talk about your wishes in a series of shorter conversations, rather than one long conversation, which can be emotionally tiring for both.

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Q. How do I start such a sensitive conversation?

​Conversations can be difficult to get started so you may find it easier to start talking about what you wouldn’t want rather than what you do want. Be clear about what you want and don’t give up as it may take a little bravery to begin. Don’t allow someone else’s issues or barriers to prevent you from expressing your wishes.  Be honest, be calm, and be determined.

It’s probably best to ensure that when you do have the conversation, you are both relaxed and have plenty of time.

Q. What if I don’t want to talk to my family about this?

A. It doesn’t have to be a family member, you can still record what’s important to you in writing and share this with your doctor or Healthcare team.

Q. Is an Advance Care Plan a legally binding document?

A. Legally a healthcare professional does not have to follow the exact instructions in your Advance Care Plan, however, these wishes must be taken into account when a decision is being made on your behalf. So please think about the Big Conversation. The more we can talk openly and make plans, the more likely it is that our wishes and preferences can be met when the time comes. We only have one chance to get it right!  If you would like any further guidance or support, please ring one of the HospiceCare nursing team who will be happy to help

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• Compassion in Dying (charity no. 1120203) booklet: www.compassionindying.org.uk

• The Dying Matters Coalition is led by the National Council for Palliative Care and aims to raise public awareness about the importance of talking more openly about dying, death, and bereavement and of planning ahead. www.dyingmatter