Advance care planning and directive
6-minute read
Key facts
- Advance care planning involves planning for your future healthcare.
- Advance care planning ensures that your future healthcare will align with your values and preferences.
- Everyone can benefit from advance care planning, but especially people who are older, have a chronic or life-limiting illness, multiple diseases or early cognitive impairment.
- Advance care planning usually involves detailing your preferences in an advance care directive and appointing a substitute decision-maker.
- The documents, legal requirements and processes for advance care planning vary depending on the state or territory you live in.
What is advance care planning?
Advance care planning involves planning for your future healthcare. The process of advance care planning helps you outline your values and beliefs and your preferences for your future healthcare. Advance care planning will help guide your loved ones and doctors to make decisions on your behalf that align with your values, in a situation where you aren’t able to do this yourself.
What is an advance care directive?
Advance care planning involves formally detailing your values and preferences regarding your future healthcare. This document is called an ‘advance care directive’, though it has different names in different states and territories. In most situations, this document is legally binding, if you signed it when you had legal capacity. Your doctor and loved ones cannot override directions stated in your advance care directive.
You don’t need a lawyer for your advance care directive to be valid, but you may need witnesses to sign it when you do. It’s also a good idea for your substitute decision-maker and doctor to sign the form.
If you don’t have legal capacity, you can still outline your wishes and preferences in an advance care directive. This isn’t legally binding, but it will ensure that your substitute decision-maker and healthcare team understand your preferences.
What is a substitute decision-maker?
Part of advance care planning also involves appointing a substitute decision-maker. This is a person who will be legally able to make decisions on your behalf about your healthcare if you can’t. Substitute decision-makers have different titles depending on the state or territory you live in.
Your substitute decision-maker should be someone:
- over 18 years old
- you trust
- who will listen to and respect your values and preferences for your future healthcare
- who is comfortable making decisions in difficult situations
You can also appoint a second substitute decision-maker, who will step in if your first substitute decision-maker isn’t able to make decisions on your behalf.
Who might need an advance care directive?
Everyone can benefit from having an advance care directive that contains their preferences, regardless of their age or state of health.
Ideally, you will complete an advance care directive when you are still able to communicate and have legal capacity (you are legally able to make decisions).
Advance care directives are especially important if you:
- are older
- have a chronic illness or multiple medical conditions
- have a life-limiting illness
- are at risk of dementia or another condition that may affect your legal capacity
What is the importance of having an advance care directive?
No one knows what will happen in the future and what health challenges they may face.
Advance care planning ensures that your future healthcare will align with your values and preferences, even if you aren’t able to make decisions for yourself. It can also help your loved ones and doctors know what you would and wouldn’t want, even if you can’t tell them.
Many advance care directives are legally binding. This means they can ensure you don’t receive health treatments that you don’t want, for example, being put on a ventilator.
How do I start advance care planning?
Advance care planning starts with thinking about what you want for your future healthcare. If haven’t yet thought about this, you can learn about palliative and end of life care. Learning about the possible treatments that may be offered if you are seriously unwell or at the end of life can help you decide what you would or wouldn’t want.
Visit Advance Care Planning Australia for information about treatments to consider in your advance care directive.
Next, it’s best to discuss your values, preferences and plans with your family, friends, carer and healthcare team. As well as helping them to understand your health preferences, the process can also help you figure out what you would want, if you aren’t sure.
Most people find it difficult and confronting to talk about being seriously unwell or dying. The Australian Government Department of Health and Aged Care has some tips for starting the conversation.
How do I create an advance care directive?
The process for creating an advance care directive varies slightly depending on which state or territory you live in. Different states and territories have different documents to complete.
Visit Advance Care Planning Australia to create a document that complies with your state or territory's regulations.
After you have created your advance care planning documents, it’s a good idea to upload your documents to your My Health Record. This means it will be available to your treating doctors if it’s ever needed.
Resources and support
- The Australian Government Department of Health and Aged Care has information and resources about all aspects of advance care planning.
- Advance Care Planning Australia has a range of resources about advance care planning and links to the relevant documents for advance care planning in each state and territory. The website also has information about advance care planning in languages other than English.