Advance Care Planning (ACP)

A non-legal record of your healthcare wishes so your loved ones and medical team know what matters to you, even if you can no longer speak for yourself.

Understanding ACP

Advance Care Planning (ACP) is the process of thinking through and recording your healthcare wishes for situations where you can no longer make decisions or speak for yourself.

It includes:

  • reflecting on your personal beliefs and healthcare preferences

  • discussing these preferences with your loved ones

  • appointing a trusted person to speak on your behalf

  • recording your wishes in an ACP

An ACP is not legally binding, unlike a Lasting Power of Attorney (LPA). You do not need a lawyer to help you make an ACP. ACP conversations usually include some aspects of the Advance Medical Directive (AMD) and LPA.

Why it's important

An ACP records your values and healthcare preferences. If a medical crisis leaves you unable to speak for yourself, your ACP guides your healthcare team and loved ones in making decisions on your behalf. This can reduce uncertainty, guilt, and conflict.

Who's it for

ACP is for anyone 21 years old and above who has the capacity to make their own decisions. This is regardless of whether you’re healthy or living with a health condition.

Everyone has different values and preferences for how they want to be medically treated. ACP is the way to make sure those are known.

ACP is particularly important for people who:

  • have a chronic condition,

  • have an early cognitive impairment

  • are frail

  • are approaching the end of life

Contact your current healthcare team to discuss your ACP.

How to prepare your ACP

Step 1: Reflect on what you want

To be able to communicate your values and preferences to others, you must first understand these yourself. Think about the quality of life you want, and the medical treatment you’re comfortable with, such as:

  • activities or experiences that are important for your quality of life

  • fears or worries you have about medical care

  • the extent of medical care you’re comfortable receiving

Thinking about your preferences can be challenging —  especially regarding situations where you're no longer able to make decisions for yourself. The ACP workbook and speaking to someone can help.

Speaking to a loved one

Involving your loved ones in the process can help them better understand your wishes, making it easier for them to speak on your behalf by sharing your views and preferences for medical care openly.

It's important to remember that such discussions do not have to be a one-time conversation. It can take a series of conversations for you to fully communicate your values and preferences.

Speaking to an ACP facilitator

If you would like to discuss your values and preferences with someone who is trained to have such conversations, make an appointment to speak with an ACP facilitator. They can guide you to discover what matters to you, and provide support when choosing your healthcare preferences.

You may have multiple sessions with the facilitator to discuss your ACP.

Find an ACP service provider

Speaking to a healthcare team

If you’re currently receiving medical care at any healthcare institution, it's important to involve your healthcare team in your ACP discussions. They'll be able to advise on appropriate treatment goals and preferences based on your medical condition.

If you have an existing chronic condition (for example, diabetes, heart disease, or chronic kidney disease) or other medical concerns, consider consulting your regular doctor.

Speaking to a religious leader or community

If you have religious beliefs, you may also wish to consult your religious leaders or community about religious considerations that could influence your decisions.

Step 2: Choose and talk to your Nominated Healthcare Spokesperson (NHS)

Your NHS is responsible for speaking on your behalf about your healthcare preferences when you're no longer able to. In such situations, the healthcare team will consult your NHS and discuss your care plan.

Most people choose a family member or a close friend, but it can be anyone you trust and feel comfortable with.

If you've made a Lasting Power of Attorney (LPA) or are intending to make one, you're encouraged to appoint the same person as both your LPA Donees (for Personal Welfare decisions) and your ACP NHS. This helps reduce conflict in making healthcare decisions on your behalf.

Your ACP can serve as a guide for your Donee, who has the legal right to make medical decisions according to your preferences.

Step 3: Document your Advance Care Plan (ACP)

You can complete your ACP without speaking to an ACP facilitator. You can use the myACP online service if you:

  • have a Singpass account

  • are 21 years old and above

  • do not have any existing serious illness

  • do not have a Preferred Plan of Care (PPC), ACP, or Disease Specific (DS) ACP

After completing myACP

  1. Once you've completed the online form, your Nominated Healthcare Spokespersons (NHS) will receive digital invitations via SMS.

  2. They'll be notified via SMS, and must accept or reject their appointment by logging in to My Legacy@LifeSG with their Singpass.

  3. Your ACP will automatically be registered once all your NHS accept their appointments.

An ACP facilitator is someone who’s certified to have ACP discussions and guide users in making decisions on their healthcare preferences.

Visit an ACP service provider if you:

  • prefer to have a conversation with an ACP facilitator and be guided through your ACP process

  • have an existing serious illness

Your ACP will be registered in the NEHR upon completing all discussions with your facilitator. Some service providers may charge a nominal fee for doing an ACP. Please check with the respective organisations for details.

Step 4: Review your Advance Care Plan (ACP)

After completing your ACP, you can view a copy of your latest registered ACP on your My Legacy dashboard . Then, you can:

  • share your ACP with your Nominated Healthcare Spokesperson (NHS) by adding them as a Trusted Person on your My Legacy dashboard. This ensures they have a copy of your latest ACP.

  • share your ACP with other loved ones who are not your NHS to inform them about your healthcare preferences.

  • update your ACP to ensure that it reflects your most current preferences as long as you have mental capacity.

When you should review your ACP

  • Every new decade of your life

  • When your preferences change

  • At every significant life stage or milestone — for example, when starting a family

  • After a medical diagnosis of a life-limiting illness or chronic condition

  • After a significant change in your functional ability that may affect your daily activities later in life

To make changes to your ACP preferences or nominations, you’ll need to create a new ACP. You may also visit an ACP service provider to do so.

If you've made changes to your ACP, inform your NHS so they're kept updated with any changes.