Advance Statements

There’s a variety of names for types of advance statements, but they are basically a statement of a person’s wishes for what will happen with their care if, for whatever reason, they are unable to make decisions for themselves.

People might make advance statements if they want to have some control over decisions that are made about them – this can be very reassuring.

An advance request is an advance statement of the types of treatment a person would prefer should they become unable to state their preferences when unwell. This can include requests around food, a preferred hospital and requests around cultural needs. They are not legally binding but if a person’s advance request is not followed they can ask why and complain if they are not happy with the explanation.

Advance decisions/directives

These are refusals rather than requests. They’re more complicated in that they are described in law (the Mental Capacity Act). People must be aged over 18 and be said to ‘have mental capacity’ (this is professionally assessed) when the advance decision/directive is made. They’re further complicated by the face that people who have been made subject to the Mental Health Act (‘sectioned’) can lawfully have their advance decision/directive overruled (doctors can give whatever treatment they feel is needed).

Advance agreements

These can be made in care plans and crisis plans, and are agreements between a person and the team/services that are supporting them. These might state preferences for types of drug treatment, frequency of visits, the role of friends and family etc. Some people have ‘crisis cards’ which have the important bits of the advance agreement on them such as contact numbers.