Irish Hospice Foundation
Toolkit for Compassionate End-of-Life Care
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In Ireland, Advance Healthcare Directives (AHD) are legally recognised. To make one, a person must be over 18 and have decision-making capacity. A person who has decision-making capacity can do all of the following: • Understand information about the decision they are making, at the time the decision is to be made. • Remember the information long enough to make a choice. • Weigh up information as part of the process of making the decision. • Communicate their decision by writing it down or by telling or showing someone what their decision is. An AHD comes into effect when a decision needs to be made, but the person no longer has capacity to make or express that decision. A person may ask you to help them make their AHD. It is ok for you to offer assistance, but they must be able to make the AHD by themselves, which means they must have decision-making capacity to do so. • If a person has a specific illness or condition, you might want to advise them to talk to their treating physician about completing an AHD so that they can discuss what treatments are medically most appropriate for their condition. • You can help them to think and talk about the treatments they do not want to have (refusing treatment) or do want to have (requesting or consenting to) in the future. • Remember an AHD must represent the person’s will and preferences and not anybody else’s. • You can help someone record their AHD by voice, video or assistive technology. • If you have helped someone make an AHD, advise them to tell those who are important to them (their family and/or friends, GP and care team) and encourage them to share copies so everyone knows what is important to them. • If a person has made an AHD, then you must consult it if the person loses their ability to make a treatment decision. • If a person has made an AHD, then any requests for treatment in it should be taken into consideration and respected as far as possible, depending on the circumstances. As a staff member: • Your role as a healthcare worker is to respect a person’s AHD. Remember they are the expert at what matters most to them. For more information on Advance Healthcare Directives and the ink Ahead Planning Pack, visit www.thinkahead.ie
e Assisted Decision-Making (Capacity) Act of 2015 fully legalises Advance Healthcare Directives, and came into effect in April 2023. More information can be found with the Decision Support Service (decisionsupportservice.ie) and the HSE (assisteddecisionmaking.ie). Simple templates are available from the Decision Support Service. e Advance Healthcare Directive included in the ink Ahead Planning Pack is fully aligned with the current legislation. Visit www.thinkahead.ie
Preparation 3
End-of-Life Care Planning and
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