My Plan What I want to happen
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My Plan
What I want to happen
1
Instructions for carer
This book is intended to support your conversation around a
care plan if someone becomes very ill
The different sections are intended to help guide the
conversation
Please make sure you record their wishes as accurately as
possible in the Anticipatory Care Plan
This can be a very difficult conversation so feel free to pause
and come back to it as appropriate
2
About my Plan
My Plan will tell people what I would like if I get very ill
The people who are important to me
The things that are important to me
How I want people to look after me when I am very ill
3
Important things to know
I can change my Plan at any time
The Plan is about the care I would like
This Plan will need to be shared with people who are caring for me when I am very ill
4
All about me
5
All about me
My name is
I like to be called
6
How I like to communicate
Talking
Yes No
Signing
Yes No
Communication book
Yes No
7
Symbols or pictures
Yes No
Object of reference
Yes No
Other?
8
People that are important to me
This could be my family, friends, key worker, neighbour
9
Planning my care
10
Help with my decisions
When I am very ill, making decisions for myself can be hard
I can choose a person to help me make decisions
People that can help make decisions about your care may be:
Friend
Family member
Carer
11
People who will help make decisions about my care
Name
Name
Name
Name
Name
Name
Name
Name
12
Name
Do any of these people have
power of attorney or
Power of attorney or
Name
13
Other people who support me
Other people might be:
Keyworker
Health care worker
Mental health support worker
Name
Name
Name
Name
Name
Name
14
Things about my care
You might want to think about:
What you would like
What you do not want
Your family/carers involvement
15
Things to do with your medical treatment
Anything else about your care and support
16
Cardiopulmonary resuscitation
If your heart stops beating, sometimes doctors can make your heart start again This is called cardiopulmonary resuscitation or CPR
You can decide if you want the
doctor or nurse to try and restart
your heart if it stops (CPR)
17
What you decide will be written
down in a care plan and shared
with the doctors and nurses
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