Advance
Care Planning
Workbook
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Address
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Voice Your
Choice
None of us knows what tomorrow will bring.
You cannot predict what might become of your
health, but you can plan ahead to ensure that
your wishes are known, should there come a
time when you are unable to speak for yourself.
Use this workbook as a guide to help you as
you think about how you’d like to be cared
for in the future, then share your wishes with
your loved ones. Voice your choice - begin your
Advance Care Planning journey today.
WHAT IS
ADVANCE
CARE
PLANNING?
If you are in an accident or have an illness that
leaves you unable to speak, who will communicate
your care preferences to the medical team?
Advance Care Planning (ACP) is the process of
planning for your future health and personal care.
It includes:
• Sharing your personal values, beliefs and goals
for care with your loved ones and healthcare
providers
WHO
SHOULD
CONSIDER
ADVANCE
CARE
PLANNING?
Everyone. You cannot predict what the future holds,
but you can prepare for your care by letting your
loved ones know what matters to you most. This can
make it easier for them to make decisions for you if
that time comes.
• Exploring your healthcare preferences in difficult
medical situations or crises which may include
end-of life circumstances
• Selecting a person to be your voice for your
preferred medical decision should you become
unable to speak for yourself
By making your wishes known, your loved ones and
caregivers need not make guesses about what you
might want or would not want.
Voice Your Choice
01
LIVING
MEANS...
Before you make a plan for your future
healthcare, start by thinking about your personal
values and beliefs. Do they influence the type of
care you would like to receive?
Let’s get started by writing down your thoughts
to the following questions:
WHAT MAKES EACH DAY MEANINGFUL? WHAT GIVES MY LIFE PURPOSE?
(For example, when I am with my loved ones, when I can enjoy the fresh air on my evening walks, when I pray,
when I can help the less fortunate)
WHAT CAN I NOT LIVE WITHOUT? WHAT MATTERS TO ME?
(For example, I cannot live without eating my favourite food, what matters to me is being able to move around on my own)
02
WHAT OR WHO HELPS ME FACE SERIOUS CHALLENGES IN MY LIFE?
(For example, being able to share my problems with my loved ones, my religion gives me strength)
HAVE I EXPERIENCED THE DEATH OR NEAR DEATH OF MY LOVED ONE?
WHAT HAVE I LEARNT FROM THAT EXPERIENCE?
THE MOST IMPORTANT ASPECTS ABOUT MY WELL-BEING (PHYSICAL AND MENTAL) ARE:
(For example, being able to talk to my loved ones, being able to touch and hug my family)
Letting your loved ones know what it means for you to live well can be helpful in the event
of a medical emergency. If you are unable to speak for yourself, your loved ones can be
your voice and inform your doctor what abilities and activities are most important to you.
Voice Your Choice
03
Now that you have considered the things that give
your life meaning, think about how you would like
to be cared for if you can no longer enjoy any of
these things.
MY CARE
WISHES
Use the scales below as you imagine each situation,
and circle the number that best reflects how you feel.
IF I BECOME SERIOUSLY ILL ONE DAY...
1
2
3
4
Do not tell me
anything about
my illness.
1
5
I want to know
everything about
my illness.
2
3
4
I want my doctors and
family to do what they
think is best.
5
I want to have a say in
every decision about
my care.
I WANT MY DOCTORS AND NURSES TO HELP ME…
1
Live for as long as
possible no matter
what my state of
health is.
04
2
3
4
5
Live meaningfully,
even if that means a
shorter life.
BEING ABLE TO TAKE CARE OF MYSELF (FOR EXAMPLE, BATHING, EATING,
MOVING AROUND) IS…
1
2
Not important.
Others can help me.
IF I BECOME VERY SICK, THESE ARE THE
THINGS/ PEOPLE I WOULD LIKE TO HAVE
WITH ME:
3
4
5
Very important.
I value my
independence.
MY GREATEST FEARS AND WORRIES
ABOUT HAVING A SERIOUS ILLNESS ARE…
Voice Your Choice
05
If an unexpected event should happen and you can
no longer speak for yourself, what kind of role do
you want your loved ones to play? Can your loved
ones be your voice one day?
MY VOICE
IF I AM GOING THROUGH A SERIOUS ILLNESS AND/OR POSSIBLY NEARING THE
END OF MY LIFE...
1
2
3
4
I would like
to be alone.
5
I would like to be
surrounded by my
loved ones.
HOW MUCH DO YOU WANT YOUR LOVED ONES TO KNOW ABOUT YOUR ILLNESS?
1
2
3
4
I don’t want them
to know too much.
5
I want those
close to me to
know everything.
WHEN YOU ARE READY TO SHARE YOUR WISHES, THINK ABOUT WHO YOU WOULD WANT
TO TALK TO. WHO DO YOU TRUST TO SPEAK ON YOUR BEHALF? THE PEOPLE YOU CHOOSE
SHOULD KNOW YOU WELL.
MY SPOUSE/PARTNER
MY FRIEND(S)
MY CHILD/ CHILDREN
MY PARENTS
MY CAREGIVER
MY DOCTOR/ NURSE
MY RELIGIOUS LEADER
06
ANY OTHERS (NOT SPECIFIED)
WHAT’S
NEXT?
Talking about your future healthcare can be difficult.
It may bring up concerns and uncomfortable
feelings. You may realise that your loved ones do
not agree with your decisions. That’s okay. What’s
important is to continue talking about it now – not
during a medical crisis.
REMEMBER
• There is no right or wrong. Approaching serious illnesses and/or dying can mean different things to different people.
• You can change your mind anytime. It can happen as your life experiences or health conditions change.
• Be patient. You may need more time to think and talk about your future healthcare.
• Care planning is a process. You don’t have to finish this conversationwith your loved ones all at once.
Remember, having the conversation and completing your advance care plan are ways to give your loved ones
the confidence to make decisions during a difficult time.
• Share your wishes with your loved ones.
Use this space to write down any other thoughts you would like your loved ones to know:
Voice Your Choice
07
Use this space to write down any other thoughts you would like your loved ones to know:
08
I HAVE SHARED THIS ADVANCE CARE PLANNING WORKBOOK WITH THE FOLLOWING PEOPLE:
Name
Relationship
Date
Voice Your Choice
09
An initiative by
Supported by
Visit www.livingmatters.sg
for more information about Advance Care Planning.