Planning Ahead

Regardless of your age or current health status, making concrete healthcare and legal plans can offer peace of mind for both yourself and your loved ones.

Advance Care Planning (ACP) is a series of voluntary discussions that allow you to document and share your future healthcare decisions with your healthcare team and family members. You do not need a lawyer for ACP, and decisions can be amended. Plan ahead with ACP so that your loved ones and caregivers will be sure of your wishes in the event that you are unable to make healthcare decisions for yourself. To learn more about ACP, visit Living Matters or Agency for Integrated Care. Get started on your ACP with these simple steps:

• Make an appointment with a trained ACP facilitator. You can ask your healthcare provider to refer you to one, or approach your social worker to assist.
• Discuss with the ACP facilitator and your loved ones what your idea of living well is.
• Choose a substitute (or proxy) decision-maker to be your voice when you are unable to speak for yourself. Note that your proxy decision-maker must be at least 21 years old. You may choose a relative, good friend or anyone whom you think will act in your best interests when you are no longer able to do so.
• Document your preferences with your ACP facilitator’s help.
• Review your ACP document when your medical condition or life circumstances change.

Advance Medical Directive (AMD) is a legal document that you sign in advance to inform your doctor that you do not wish to use any extraordinary life-sustaining treatment to prolong your life, in the event of terminal illness or unconsciousness. You can cancel your AMD at any time by completing a form or writing a letter to the Registrar of AMDs. You will need one witness. To learn more about AMD, visit https://www.moh.gov.sg/policies-and-legislation/advance-medical-directive . You need to fulfil the following criteria if you wish to make an AMD:

• You must be above the age of 21 and of sound mind.
  
  
• Three doctors (including your hospital doctor) must all certify that you are terminally ill. Two of the doctors must be specialists.
  
  
• If there is a disagreement between the doctors, the doctor-in-charge can review it. If there is still no agreement, the Ministry of Health will appoint three additional specialists to review your case. If all the three appointed specialists still cannot certify that you are terminally ill, the AMD cannot take effect.
  
  
• You need to complete and sign the AMD form in the presence of two witnesses – your doctor and someone who is above the age of 21.
  
  
• Both witnesses cannot stand to gain anything from your passing.

Lasting Power of Attorney (LPA) involves appointing someone you trust to make decisions and act on your behalf should you lose the mental ability to make these decisions yourself in the future. Loss of mental capacity may happen as a result of a stroke, mental illness or accident. The LPA should only be used when you are certified to be incapable of managing your own affairs. Should you regain your mental capacity again, your done should step aside to allow you to manage your own affairs. You can appoint more than one person to be your donee. Your donee must be at least 21 years old and must not be bankrupt if you are appointing him / her for property and affairs matters. To learn more about making an LPA, visit www.publicguardian.gov.sg . Your donee(s) can help you to act in the following areas:

• Your personal welfare
• Your property and affairs
• Both your personal welfare as well as property and affairs

You need to fulfil the following criteria if you wish to make an LPA:

• You must be at least 21 years of age.
• You must possess mental capacity to make your own LPA.
• You must not be bankrupt if you are appointing a property and affairs donee.
• You must register your LPA with the Office of Public Guardian for it to be legally valid.

A will ensures that your loved ones are provided for according to your wishes after your death. The contents of this legal document describe your estate (which refers to all of your money, savings and assets) and how it will be distributed among your beneficiaries after your death. Instructions on other issues such as the care of minor children and special needs children, as well as formation of trusts may also be covered in your Will. If you pass away without a Will, your estate will be distributed based on the Interstate Succession Act. As such, your estate may not be distributed to people whom you wish to provide for after your death. Wills made in Singapore are governed by the Wills Act. Although you do not need a lawyer to make a Will, many people seek legal advice to avoid issues that can cause their homemade Will to be invalid. Consider visiting a free legal clinic to find out more. For a list of free legal clinics in Singapore, visit https://legalclinics.sg. To learn more about making a Will, visit https://singaporelegaladvice.com/law-articles/how-do-i-make-a-will/.

If you feel overwhelmed or find that you need assistance with planning ahead, please speak to your cancer care team about it.