Safeguarding Ireland urges people to make an Advance Healthcare Directive

Just 4% have their healthcare wishes recorded for if they lacked capacity

Safeguarding Ireland are encouraging more people to put in place and Advance Healthcare Directive – a healthcare plan – as just 4% of people in Ireland have one according to new research from RED C.

The poll carried out on a representative sample of 1,000 adults found that – just 23% understood what an Advance Healthcare Directive is, and just 4% said that a healthcare professional had ever asked them if they have one.

An Advance Healthcare Directive is a document in which a person writes down their future healthcare decisions including refusals and consents on treatment, surgery, medicines and resuscitation.

It only comes into effect if in the future a person then lacks capacity to make, or communicate, those decisions. This could be due to the progression of a frailty, dementia, a serious illness, a physical or intellectual disability, or a sudden accident. More information is available at

Safeguarding Ireland Chairperson Patricia Rickard-Clarke said the uptake of Advance Healthcare Directives is very low in Ireland compared to other countries, and more awareness and action is needed.

“Making one is free of charge and not difficult to do. It is an important part of protecting rights and ensuring that our wishes will be respected if in the future we didn’t have decision-making capacity for healthcare decisions. It is also better for doctors and families.

“Safeguarding Ireland recommends that all adults, and particularly those using healthcare services, make an Advance Healthcare Directive and share a copy with those who need to know about it.”

Commencing this week, safeguarding Ireland will be promoting the simple ways to make one. The recommended steps are to access and complete one of the two available Advance Healthcare Directive templates which are at:

An Advance Healthcare Directive includes three key parts which are:

  • Refusals on life-sustaining treatments, artificial nutrition, surgery, medicines and resuscitation
  • Consents on medical and treatment options, including pain relief and where someone would like to be treated
  • Appointing someone a person chooses and trust, called a Designated Healthcare Representative, to ensure the plan is correctly interpreted and complied with.

Once made – healthcare professionals are bound to adhere to a person’s refusals and to make every effort to provide the treatments they would like to receive. Also, there is clarity on who has authority to act on a person’s behalf.

Further findings in the RED C research, carried out last month, were that for those that had heard of an Advance Healthcare Directive but don’t have one (19% of people) the reasons were:

  • 62% had never really thought about it
  • 53% have no current health problems and believed they didn’t don’t need it
  • 42% didn’t know how to go about making one
  • 31% considered themselves too young to need one
  • 31% were concerned that it would expensive to get one
  • 31% didn’t know anyone else with one so it’ wasn’t a priority.

Ms Rickard-Clarke added that once a person has made an Advance Healthcare Directive it is important that those who need to know about it do and the following should all be given a copy: the person’s Designated / Alternative Healthcare Representatives, Family Doctor (GP), current healthcare professionals a person is engaging with, the Emergency Department if admitted to hospital, the person in charge if living in a healthcare or residential facility.

She added that there can be confusion on the role of a ‘next of kin’, but the law is clear on this. “People sometimes incorrectly think that an available family member, or ‘next of kin’, can step in and make healthcare decisions on another family member’s behalf. This is not the case. A next of kin can be a contact point, but has no authority regarding another person’s healthcare decisions unless appointed as their Designated Healthcare Representative.”

More information is available at

Further Information Ronan Cavanagh, Cavanagh Communications: (086) 317 9731.

Safeguarding Ireland promotes safeguarding of adults to protect them from all forms of abuse by persons, organisations and institutions and to deliver a national plan for promoting their welfare.

Safeguarding means putting measures in place to uphold our rights, to support our health and wellbeing, to reduce our risk of harm – and to empower us to protect ourselves. Safeguarding involves ourselves, our families, services and professionals all working together to prevent and respond to adult abuse, neglect or coercive control.

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Region: Nationwide