How does a person with capacity make an advance statement of wishes?
Anyone can make an advance statement of wishes. It does not have the legal power of an ADRT, but it is excellent evidence of a person’s views and wishes, and it must be considered by decision-makers. In addition, the MCA statutory checklist includes the requirement to consider, among other matters, ‘the person’s past and present wishes and feelings (and in particular, any relevant written statements made by him when he had capacity.’ (MCA s4(6)(a)).
It is part of good care planning to encourage someone to have as much input as possible into their care plans. There is no set format for advance statements of wishes: they should be in the person’s own words, and as clear as possible so that they can be used in making best interests decisions if the person’s capacity should lessen to a point where they cannot make their own decisions.
It is essential to ensure they are at the centre of the care plan, and that the person with capacity has a chance to revisit them and change or update the contents when care plans are reviewed or more often if they wish.
When would an advance statement of wishes come into effect?
Statements of wishes can apply from the moment they are created but are of particular value if or when the person loses capacity to make relevant decisions. They enable the person’s voice to be heard when they can perhaps no longer express what is important to them.
What is the legal status of advance statements of wishes?
Advance statements are not binding on professionals or others in the way that ADRTs are. However, they are hugely valuable pointers to the wishes and feelings of the person, so they are an essential part of best interests decision-making by others where necessary.
The MCA specifies, in the statutory checklist of how to make best interests decisions, ‘the requirement to consider, among other matters, ‘the person’s past and present wishes and feelings and in particular, any relevant written statements made by him when he had capacity.’ (MCA s4(6)(a)).
If someone changes their mind, with capacity, about an advance statement of wishes, what should be done?
With capacity, everyone can change their mind. A person’s interests and preferred activities, and even what they like to eat, might change with increasing frailness or simply because the person has discovered something new. Care providers should facilitate changing the care plan to reflect a person’s current wishes but if someone loses capacity, a recorded statement of wishes is a really useful pointer to what is (or has been), important to them.