Anyone can share their care wishes in case they cannot make decisions in the future.
You can record wishes about healthcare or treatment in a document. You can also get help if you need support with making decisions.
Thinking about your wishes
Take some time to think about your wishes, values and what is important to you.
It can help to think about:
- medical care you may want or do not want
- who can support your wishes
- where you want to have care
- other wishes about everyday care or funeral arrangements
What medical care you want or do not want
Think about specific healthcare or treatment you may want to refuse or request.
It can help to discuss specific details with your GP or hospital doctor. They can help you understand treatments and situations that may apply to you in the future.
Refusing healthcare
You can refuse certain treatments in advance even if it may lead to your death.
If you create a document, you need to include the:
- types of treatment you do not want
- situations where you do not want the treatment
If you refuse some treatments, you will always be offered basic care. For example, personal hygiene.
Examples of treatments people record in advance care directives
Examples of treatment include:
- mechanical ventilation - where a machine helps you breathe
- artificial hydration - such as giving fluid through a drip
- artificial nutrition - such as feeding by tube through your nose or
- cardiopulmonary resuscitation (CPR)
- haemodialysis - a procedure to remove waste products from your blood if your kidneys are not working properly
- chemotherapy
- certain medicines
Requesting healthcare
You can record requests for specific treatments. For example, if you have a condition that you know responds well to a specific treatment.
A request for treatment is not legally binding. But it shows your wishes and preferences.
If you include this information in an advance healthcare directive, healthcare workers must:
- consider the treatment in a situation where it is relevant
- provide reasons if they cannot follow a request - they record the reasons in your healthcare record
- give a copy of the reasons to your designated healthcare representative if you have one
Who can support your wishes
You can explain your wishes to:
- people close to you such as family or friends
- healthcare professionals involved in your care
This can help them understand what you would want in a situation where you cannot make decisions.
But if you want someone to act for you in a formal way, you need to:
- appoint a designated healthcare representative - they ensure people follow your advance healthcare directive
- give someone authority to manage your welfare (enduring power of attorney)
You can name more than 1 person.
Becoming a designated healthcare representative - decisionsupportservice.ie
Making an enduring power of attorney - decisionsupportservice.ie
Where you want to have care
You can list places in order of preference.
For example, in:
- your home
- a hospital or hospice
- a nursing home
- another family home or with a friend
- another place you live or stay
You can also explain what you would like to happen if your health gets worse. For example, you would like to go to hospital if it could help you to live longer.
These wishes are not legally binding. But knowing your wishes can help your family and healthcare professionals to make decisions.
Recording your wishes
You can record your wishes in an:
- informal document - for wishes that are not covered by law
- advance healthcare directive - a legal document that healthcare professionals must consult
Tell people if you make an advance healthcare directive. This can include your GP, hospital doctor, family or friends.
Tell your emergency contact where to find the documents in case of an emergency.
Making an advance healthcare directive
You can make an advance healthcare directive when you:
- are age 18 or older
- have the ability to understand a decision and the consequences (decision-making capacity)
Healthcare professionals must consult the directive if you cannot make a treatment decision.
You can include:
- treatment you do not want
- treatment you want doctors to consider
- who you want to be your designated healthcare representative
An advance healthcare directive must be a written document. You need to sign the document and get 2 witnesses to sign it. If you appoint a designated healthcare representative, they must sign the document too.
Advance healthcare directive template
Making an advance healthcare directive - decisionsupportservice.ie
Get support to record your wishes
If you have a long-term condition, your healthcare team may ask you about your wishes for the future. They can discuss your treatment options and include your wishes in your healthcare record.
Irish Hospice Foundation resources
The Irish Hospice Foundation has a planning pack for recording your wishes.
Get a planning pack - hospicefoundation.ie
Decision Support Service
The Decision Support Service helps adults who need support with their decision-making capacity.
For example, if:
- you have a disability or a condition that affects your ability to make decisions
- you want to plan for a time when you may lose the ability to make decisions
- an organisation is not sure about your ability to make decisions - for example, a bank or a hospital
Freephone: 01 211 9750
Email: queries@decisionsupportservice.ie
Website: decisionsupportservice.ie