Plan now for choice & control at the end of life
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Your future

Before making any choices, you should Register on the web site. If you have previously registered then please login. Register and login are seen in grey in the top right hand side of the screen.
By registering and / or logging in all your choices will be saved on the secure server so that you can return and see your previous choices. These can be altered at any time.

Expressing what is important to you

Your hopes and aspirations towards the end of your life - these may include tasks to be completed, decisions to be made, relationships to be enjoyed, things to be put right.

I am physically fit and I would hope to be able to continue to lead an independent life.

Category:

My Future

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.

 

Concerns about the future

Worries about your health and wellbeing - the things in life that matter to you that you would want to preserve if you become ill and are no longer able to cope with normal tasks.

I am not afraid of death, but I am afraid of dying. I would not want to be in pain.

Category:

My Future

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.

My health has not been good and I am grateful for support from my family and friends. I hope that I would not become a burden.

Category:

My Future

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.

Concerns about people close to you - how they should be informed about your illness and how they might help. 

I would hope that my partner and children will be kept totally informed of my situation.

Category:

My Future

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.

Past experiences of coping with difficulty - for instance, you might want to be able to exercise, listen to music or engage in some other favourite activity.

I have found that listening to my favourite music calms me when I am distressed.

Category:

My Future

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.

Your quality of life - whether it is more important to you to live for longer, or perhaps live for a shorter time but have a higher quality of life.

I value quality of life far and above how long I might live.

Category:

My Future

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.

Organ transplantation

If you wish to leave your organs for donation, please visit the Organ donation website

Or you may wish to make a statement.

I am registered as an organ donor. I hope my wishes will be respected if at all possible.

Category:

My Future

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.

Who supports you

You might want to mention those people who you would turn to for support.

If I need support, I would hope that my partner and children might fulfill this role.

Category:

My Future

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.

 

Faith and belief

Write down what you would want.

I would like to attend religious services regularly.

Category:

My Future

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 would like to receive visits from religious leaders.

Category:

My Future

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 don't wish to have visits or conversations about faith and beliefs.

Category:

My Future

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 have completed this section. However, if you have additional wishes relating to your future, please select 'Add Statement' under 'Document Builder'.

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