Overcoming the Misconceptions of Advance Care Planning

Healthcare Support Group

Overcoming the Misconceptions of Advance Care Planning

Would you consider making an Advance Care Plan (ACP)? ACP is the process of planning your future healthcare and personal needs with your loved ones and healthcare professionals.

In an ACP conversation, you are guided to understand your values and beliefs, which help you to plan your preferences and wishes regarding future healthcare decisions and treatments. Your ACP, preferably documented, gives your loved ones and the healthcare team a clear understanding on the quality of care you expect and to act in your best interests [1]. 

In some cases, a healthcare spokesperson is appointed to represent your preferences and speak on your behalf [2]. Be sure to appoint someone who understands you and respects your wishes.

According to the Ministry of Health, the number of completed ACP in Singapore has risen to 4,500 instances in 2018, which was more than double the number in 2015 [3].

It is possible, however, for us to be discouraged from committing to this important process due to misconceptions. Let's address some common misconceptions and the facts that debunk them:

Misconception: ACP is only for the elderly or those who are ill.
Fact: ACP is for everyone regardless of their age and health conditions.

We do not know when a medical emergency can happen. Hence, any ACP discussions and planning should be carried out early when your memory is still intact, when you have the physical and mental capacity to hold conversations and make informed decisions [4]. As your mental capacity declines, you may find it difficult to express and communicate your wishes and care preferences. To facilitate such discussions and planning, a wide range of ACP touchpoints are made available in the community, such as selected community centres, polyclinics or hospitals [5]. TOUCH also provides ACP services onsite and online for your convenience.

Misconception: ACP is too expensive.
Fact: ACP is affordable for Singaporeans.

In Singapore, the cost of ACP typically ranges from $0 to $50, depending on the service provider. It can be done at polyclinics, government hospitals or via social care providers [4]. Putting aside the cost factor, the only thing that could be costly is the time spent on it. Even so, the choice and control over decisions that ACP offers, along with the ability to reduce the burden on your loved ones who would otherwise have to be involved in the decision making, far outweigh the time required [6].

Misconception: I cannot change ACP once documented.
Fact: ACP is an ongoing process.

Your medical conditions and care preferences could change as you progress through the different life stages and experiences. ACP is not set in stone, so you may review or update them at any point of time. Engage in continuous conversations with loved ones or healthcare professionals to update documents and share any latest information [6]. Cultivate the habit of revisiting your plans regularly to ensure that your wishes are up-to-date and aligned to your current values and goals [6].

Regardless of your age and health conditions, you will have values and preferences for how you want to be cared for. Discuss your wishes and preferences openly and honestly with your loved ones and healthcare professionals. Seeking out relevant resources and reaching out to an ACP facilitator could be helpful in guiding you through this process.

Having an ACP ensures that you have a peace of mind and goes a long way in improving the quality of your end-of-life care. Start thinking of your preferences and making your ACP early!

TOUCH Professional Deputies & Donees (TPDD) was set up in 2019, following the launch of the PDD scheme by the Ministry of Social and Family Development in 2018. TPDD is part of TOUCH Community Services’ efforts to build enabled communities and strengthen family relationships. Leveraging its three decades of community service, including serving the elderly and people with special needs, individuals can be assured of reliability and service continuity. TPDD has a pool of professionals certified and registered with the Office of the Public Guardian (OPG). Individuals who do not have a suitable Donee or replacement Donee are now given the option to appoint TOUCH as their Professional Donee (PD) to manage their Personal Welfare, Property & Affairs, or both, when they lose mental capacity. TOUCH also partners external stakeholders like lawyers, estate planners and Trust companies for some aspects of the work. TOUCH’s Professional Deputy can also apply to the Court to act in the best interest of individuals who have lost their mental capacity. 

1. “Advance Care Planning” Dementia Hub SG, https://www.dementiahub.sg/living-well-with-dementia/advance-care-planning/ 
2. “Advance Care Planning in Singapore: Why and how to get started” Singapore Legal Advice, 1 Apr. 2019, https://singaporelegaladvice.com/law-articles/advance-care-planning-singapore-get-started/ 
3. “Tools available to encourage discussions about end-of-life care” Ministry of Health Singapore, 18 Jul. 2019, https://www.moh.gov.sg/news-highlights/details/tools-available-to-encourage-discussions-about-end-of-life-care 
4. “Experts debunk 5 ACP misconceptions” Living Wishes, https://livingwishessg.com/blog/acp-misconceptions/ 
5. Michael, Chong. “Advance Care Planning – How to take control of your health and life with ACP” Ninkatec Right at home, https://ninkatec.com/advance-care-planning/
6. “Preparing for the unknown: Advance Care Planning” National Heart Centre Singapore, 31 Mar. 2023, https://www.nhcs.com.sg/news/murmurs/preparing-for-the-unknown-advance-care-planning