Why do this now, not later
These conversations are easy to put off. But every document here only works if the person still has mental capacity when they make it. Once that's lost, some options close for good. You don't need to sort everything in one go — just start.
ADRT — refusing a treatment in advance
An ADRT (sometimes called a living will) lets someone refuse a specific treatment in a specific future situation, for use only if they later can't speak for themselves. Done properly, it's legally binding — doctors must follow it.
To refuse life-saving treatment, it must:
Be written down, signed, witnessed, and say "even if my life is at risk as a result." Miss any of these and it's not binding — doctors can still take it into account, but don't have to follow it.
Vague phrases like "no heroic measures" aren't enough — it needs to name the actual treatment and situation.
ADRT, DNACPR, ReSPECT — the difference
These three get mixed up constantly:
Important: a DNACPR form only ever affects CPR. It never means other care or comfort is withheld.
LPA for Health and Welfare
This lets someone appoint an attorney to make care decisions for them if they lose capacity. It's a separate document from the Property and Financial Affairs LPA.
One thing to watch
If a Health and Welfare LPA is made after an ADRT, and covers life-sustaining treatment, it can override the ADRT. Get advice if both are in place — don't assume they just work together automatically.
LPA Video Guides — free
Five short videos explaining LPAs in plain English — a good place to start.
NHS Continuing Healthcare — Fast Track
If the person you care for is deteriorating quickly, they can be fast-tracked for NHS-funded care:
- A doctor or nurse fills in one form — no lengthy panel process
- Not means-tested — savings and income don't matter
- Care should start within 48 hours of acceptance
- Works at home, in a hospice, or in a care home
Palliative and hospice care
Palliative care is about comfort and quality of life, not curing an illness — it can run for months, not just the final days. Hospice care is free, and covers far more than a bed: symptom management, day services, and support for family too.
What to do next
- Ask the GP or care team what's already in place
- If making an ADRT, be specific — and use the exact wording if it covers life-saving treatment
- Get advice if both an ADRT and a Health and Welfare LPA exist
- Ask directly about NHS Continuing Healthcare Fast Track — don't wait to be offered it
- Keep copies somewhere family and the care team can actually find them
Sources
- NHS — Advance decision to refuse treatment
- Age UK Factsheet 72 — Advance decisions and living wills
- NHS — DNACPR decisions
- Resuscitation Council UK — DNACPR and ReSPECT
- NHS — NHS continuing healthcare
- Marie Curie — NHS continuing healthcare
Checked against these sources in July 2026. Rules can change — always check GOV.UK, NHS.UK, or ask the care team for the current position.