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Talking about your wishes to improve the future

Posted on 21 April 2017


Pilgrims nurse Maria works with families to help them start the conversation.

‘Advance Care Planning’ or ACP is an important talking tool that hospices, GPs and other professionals can use to help someone plan quality care towards the end of life – it’s also a tool that anyone can use to express their wishes. Pilgrims specialist nurse Maria Marley explains. 

Serious illness and ageing bring challenges that it’s natural to avoid thinking about. At the same time, planning ahead and making your preferences known is a good way to make sure that anyone who provides care for you, whether that’s family or health professionals, tailors that care to your wishes.

I am a specialist nurse at Pilgrims Hospices. Earlier this month we launched a new pilot workshop in our Thanet hospice inviting people using our services to talk about their future care and wishes. 

Called ‘Advance Care Planning’ the workshops give the information and opportunity to discuss experiences or concerns about expressing their preferences and wishes for their future care. Family and friends can be there too if the individual wants that. 

I want to share just five of the benefits people have found by coming to these sessions because these can just as easily be achieved if you decide to use this talking tool yourself or with your GP.

Starting the Big Conversation with Advance Care Planning can mean:

We support people to take that all -important first step to talk about their needs.

1) Conversations that support individual care

The conversations help the healthcare team involved in the person’s care to know what is important to that person, such as their physical care, values and beliefs. This might also help them to answer the questions people have like ‘Who will care for my animals?’, ‘Who will support my loved ones?’, ‘Where is my preferred place to be cared for?’. It also gives people a chance to say what they don’t want to happen. 

2) You can review your wishes over time

Advance Care Planning should be an on going conversation, so you can keep reviewing your wishes if these change. It’s not legally binding but it helps us know how the person wants to be cared for. It’s been found to be one of the most important ways we can ensure reliable focused care. 

3) A starting point for talking with family

When someone is ill, there may be conversations that their family know they need to have but they are really worried about starting. The person themselves may also find it very hard to express what they are feeling or what they would like. What we do through ACP is to give people a starting place to talk about their needs and experiences. 

4) Expressing wishes formally or informally

The conversation doesn’t have to be formal and isn’t legally binding, although if someone has a terminal diagnosis that may lead to a loss of capacity then having a formal, legal record – known as an ‘Advance Decision’ will help their healthcare team to continue to ensure they are enabling that person’s individual wishes and choices should that person lose capacity to express those wishes.  

You don’t need to be ill to express your wishes. I have started these conversations with my own family at home.

Once families talk about their wishes people can feel a huge sense of relief.

5) Inspiration for everyone to talk more openly 

So far the workshops I am running have proved hugely popular and have been fully subscribed each time. I think this shows the importance of having these ‘Big Conversations’.

Once families talk about their wishes people can feel a huge sense of relief. Of course, you don’t need to have a terminal diagnosis to express your wishes. I have started having these conversations with my own family at home. I find it comforting knowing my wishes will be fulfilled. Whether people come to Pilgrims for support or prefer to talk to their GP, the key is to give people the tools and the confidence to be more open. 

Join us for free Advance Care Planning events, 8-14 May 2017

Pilgrims is running a series of free Advance Care Planning sessions to give you ideas for how to express your wishes.

Who’s it for: All are welcome – including Pilgrims patients, carers, family and friends and members of the public.


• PHC: Monday, 8 May, 10am to 12noon

• PHT: Tuesday, 9 May, 1:30pm to 3:30pm

• PHA: Friday, 12 May, 2pm to 4pm

These are part of a series of free community events across east Kent between 8-14 May, national ‘Dying Matters’ weekThe national theme is #What Can You Do? and looks at ways people can be more active in planning for dying and death and helping support those who may need it in times of grief and bereavement, be they friends, family or in your wider community. Click here to read about the other events or find us on Facebook or Twitter to join in the conversation and share your stories and pictures too using the hashtag #Whatcanyoudo

If you or a member of your family is coping with a terminal illness and you want to find out about the full range of Pilgrims services please click here to find out more.



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