HealthInfo Waitaha Canterbury
Medical care guidance plan
Whakamaheretanga manaakitanga whakarauora
When a person cannot make a decision about their own care, other people have to make those decisions for them. For example, if they have dementia or have had a serious stroke. That is when health professionals use a medical care guidance plan.
A medical care guidance plan helps health professionals decide how best to treat that person, bearing in mind what the person would prefer if they could speak for themselves. It is especially important if different doctors are looking after them. For example, if they have to go into hospital.
This plan is different from an advance care plan.
A person creates an advance care plan with the help of their general practice team or other health professional. They do this while they are still able to decide what they want in the future. But a medical care guidance plan is created by a person's doctor (usually their GP). This is done when the person cannot make decisions for themselves anymore and do not have an advance care plan.
The person may still be able to contribute to the plan. For example, if they are sometimes more aware and lucid. But whānau (family) and friends have an important role because they know the person and what might be important to them.
It may take some time and a lot of discussion to decide on a plan for your friend or whānau member.
Information in a medical care guidance plan
The plan includes important information such as:
- what is happening with the person's health right now
- what doctors think might happen in the future
- what might be the best way to care for them.
To help doctors make these decisions, the plan also includes information about the person and what they would want to happen. It suggests:
- how to achieve comfort and dignity at the end of the person's life
- whether treatment should just aim to make them as comfortable as possible (palliative care) or try to restore them to the best health possible
- whether they want to be resuscitated if their heart stops beating and they stop breathing.
It is good to talk about the plan with the health professional who is helping your loved one.
Things to think about for the plan
You can provide a lot of information to help your loved one's doctor create the best medical care guidance plan for them. This includes:
Personal beliefs and preferences
- What makes them happy and brings them pleasure?
- What makes them unhappy and causes distress?
- Do they like to have a lot of people around them or do they like more peace and quiet?
- Do they have any important religious, spiritual or cultural beliefs that affect what they want for the end of their life?
- Have they ever talked to you about someone who was very unwell or dying and said what they would want to happen if they were in that situation?
Family wishes
- What do whānau members hope for this person?
- Do whānau members have any fears about what might happen?
- What help can whānau and friends offer?
Health and treatment
- What is their health like at the moment?
- What is likely to happen in the future?
- Have they ever said where they want to be cared for (at home, in a residential care facility, in a hospital)?
How the plan will be used
The plan outlines what is in the person's best interests. It will follow their wishes if it is possible, clinically appropriate and legal. But some treatments might not be appropriate and might not be offered. The person's carers will talk to you about what is happening as their condition progresses.
Storing and using the plan
The plan is securely kept with your loved one's health records. The plan will be transferred with them if they are moved to a new place. For example, if they have to go to hospital.
It will not be activated or used until it has been signed by your loved one's doctor. They will only do this after consulting the person who has their enduring power of attorney. So, you should feel safe and comfortable discussing all options while the plan is being created.
Once it is activated, doctors will use it to guide them when they make decisions about your loved one's care.
If you have any further questions about what a medical care guidance plan includes, how it can help your loved one and how you can contribute, talk to the health professionals caring for your loved one.
Written by Advance Care Plan implementation team, Te Whatu Ora Waitaha. Adapted by HealthInfo clinical advisers. Last reviewed July 2024.
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Review key: HIDLT-326665
