What is Advance Care Planning?  

Advance Care Planning (ACP) is a process that involves reflecting, recording and sharing your care preferences with your loved ones in advance so that they know what to do in the event that you lose the mental capacity to make decisions on your own. 

What does Advance Care Planning Involve?

What does Advance Care Planning Involve?

1. Reflecting

Reflecting involves exploring your personal values and beliefs, as well as your care preferences in certain medical situations. 

 

Some examples of care preferences include whether to continue to try all medical interventions or to make comfort the goal of your care when the doctor deems that you have a low chance of recovery.  

2. Recording

Ideally, your wishes and preferences should be written down so that there is a record for your loved ones to refer to. 

3. Sharing

When you’ve reflected and recorded your care preferences, share them with a loved one whom you trust. This individual, otherwise known as a Nominated Healthcare Spokesperson (NHS), will be your voice when you lose the mental capacity to make decisions on your own. Click here to find out more about what an NHS is. 

 

4. Reviewing

Your are encouraged to review your ACP periodically. If your preferences change, which can happen with new experiences or changes to your health, you should inform your loved ones and important others and provide copies of your new plan.

 

Officialising Your ACP

You may also officialise your ACP by making an appointment with a trained ACP facilitator. Officialising your ACP means that doctors have a record of your care preferences through the National Electronic Healthcare Record (NEHR). Click here to learn more about where you can officialise your ACP.

 

What is a Nominated Healthcare Spokesperson?

Your Nominated Healthcare Spokesperson (NHS) is someone whom you choose to be your voice to speak on your behalf if you can no longer do so in the future. Here are some things to consider when choosing your NHS. He or she should: 

Be above

21 years old

Be willing to be your NHS

Know your preferences, values and

goals

Know my preferences, values and

goals

Be able to

handle

stressful situations

Able to

handle

stressful situations

Be able to

carry out

your care preferences 

 

Types of ACP

There are three types of ACP offered in Singapore, namely the General, Disease-specific 

and the Preferred Plan of Care (PPC) ACP.

General

For healthy individuals. Helps individual state his/her values in life (e.g. what gives his/her life meaning) and goals of care in the event that he/she loses the mental capacity to make decisions on his/her own. 

Disease-

Specific

Preferred

Plan of Care

For patients with progressive, life limiting illness with frequent complications. Helps individual determine his/her goals of specific disease-related care should complications result in bad outcomes.

For patients at an advanced stage of illness where one will not be surprised if they pass away within 12 months. Helps individual decide his/her goals on medical intervention in the event of a potentially life-threatening crisis, as well as individual’s preference on place of treatment, care and death. 

 

Misconceptions about ACP

View some common misconceptions about ACP below. 

ACP is not a conversation about death. It is an ongoing discussion about your healthcare preferences. ACP encourages you and your loved ones to discuss and understand what matters most to you - your values, beliefs and wishes. 

ACP is not only for the elderly and sick. It is actually for everyone. Healthy individuals, young adults, working professionals and retired seniors are encouraged to discuss about the type of healthcare they prefer as life is unpredictable.

Completing your ACP does not mean you are telling doctors to not treat you, but rather it means that you want them to treat you the way you want to be treated. You may indicate that your preference is to withdraw active treatment, or receive other treatment where clinically appropriate.

If your doctor brings up the topic of ACP, it does not mean that they have given up on you. ACP helps the medical team to understand your wishes and deliver the type of healthcare and services that align with your care preferences. Your doctor will always provide care that is in your best medical interest. This includes considering your views on matters like life-sustaining treatment.

Completing your ACP does not mean that you can't change your care preferences. ACP is an ongoing process so your care wishes are not set in stone and your ACP document can be changed as and when you wish to. 

 

Unsure about the differences between ACP and other planning tools? Well, we’re here to help!

Read on to find out more.

Advance Medical

Directive (AMD)

Advance Care

Planning (ACP)

Lasting Power

of Attorney (LPA)

Legal document

Non-legal document

Legal document

Does not require a lawyer, but requires the joint presence of a doctor and witness who must not stand to gain from your death.

Does not require a lawyer.

Requires an

LPA certificate

from either an accredited medical practitioner, a lawyer, or a psychiatrist.

Involves telling your doctor that you do not want extraordinary life-sustaining treatment to prolong your life if you become terminally ill and unconscious, where death is imminent.

Involves informing someone (E.g. your loved ones) about your preferred health and personal care options in advance, in the event that you lose the mental capacity to make decisions on your own. 

Involves appointing a donee to make decisions in two broad areas - property and financial matters, as well as personal welfare decisions - on your behalf when you no longer have mental capacity to do so.

Doctor and medical team may decide not to continue with any extraordinary life-sustaining treatments.

Guides medical team to make treatment decision in consult with your Nominated Healthcare Spokesperson (NHS) if you are no longer able to make decisions for yourself.

Donee may make decisions on your behalf relating to property and financial matters such as dealings with banks, as well as personal welfare decisions such as where to live at the end of life, but may not make any decision with respect to the carrying out or continuation of life-sustaining treatment. 

Impact

Processes

Involved

Legality

Requirements

ACP vs Other Planning Tools

 

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