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What matters - considerations for your Advance Statement

 

Medication

You may wish to make known your preferences to do with the medicines you take.

I am on a number of medications for high blood pressure and arthritis. I am anxious about taking too many medicines and would prefer as few as possible.

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What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

 

Health concerns

You can write down any worries about your health at the moment or any concerns about what might happen to you as you get less well. To do so, please select 'Add Statement' under 'Document Builder'.

You could say what issues or circumstances, not mentioned under previous topics, are really important to you or your family. You might also wish to write about what you feel is happening to you, what you may be worried about, and what you know about your illness. This could help your carers know your expectations so they can try and meet these.

If there is a very limited possibility that I will return to that life style, then I would hope my Advance Decision will come into effect.

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

If there is little prospect of my recovery so that I can function as an independent person and be socially active, then I consider that that is not living but rather existing. I would hope that all treatments to sustain such poor quality of my life be terminated.

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

'I have been physically and socially active and led an independent life.' I recognise that I might not recover fully, but would at least wish to be able to converse with my family and friends. If that would not be possible, then I would hope my Advance Decision will come into effect.

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

Other preferences and wishes

You can add any additional preferences, wishes, beliefs and values that you hold which have not been covered in any of the topics by selecting 'Add Statement' under 'Document Builder'.

Funeral preferences

You can suggest the style of funeral you want, whether you want burial or cremation, and any specific instructions regarding the service or where you would like to be buried. For example: 

Would you like a large or small ceremony?  

What style of funeral you want - religious or secular?

I would prefer a small / large ceremony.

I would prefer a religious / secular ceremony.

Here are the songs / music that I feel say something about me.

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

What music (songs / hymns) do you want played?

What poems, readings or prayers would you like? 

These are the songs / music that I feel say something about me.



I would like any of the following to be read at my funeral .......

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

Do you wish to be buried or cremated? 

I would prefer:

If cremated, what would you like done with your ashes?

or

If buried, do you have a particular place (cemetery) in mind?

Category:

What Matters

Statement of Preferences

Please enter a valid statement.
As this is a statement of preferences you can only use words such as wish, like, hope or prefer. Please edit the statement below (click the box to change the text) then click 'Add to Current Document' when ready.

 

Final steps

You have now completed your Advance Statement of preferences, wishes, beliefs and values. If you would like to go on to create an Advance Decision, you can simply continue by selecting the link below.

If not, select the 'Download' option under 'Document Builder' to save your Advance Statement. You will then need to:

The same steps apply to an Advance Decision, if you decide to create one at a later date.


Advance Decision - dementia

 
Document Builder
Advance Statement
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Advance Decision
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Finalise and download

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Please add your statement

Please enter a valid statement.