What is Advance Care Planning?

Advance Care Planning is a voluntary process where you might have many conversations with a health professional about your future health decisions based on your current health. As part of your planning you would create an Advance Care Directive. 

 What is Advance Care Directive (ACD)?

An Advance Care Directive is the legal, voluntary document that you fill in that guides clinicians, family members and advocates on your health choices that only comes into play when you are no longer able to communicate those choices for yourself.  

Why do we need an Advanced Care Directive?

Often modern medicine is focused on keeping a person alive at all costs, and there are many medical interventions that can be used to that end. However, there is a level of quality of life that we might choose rather than having medical interventions such as resuscitation, ventilation, artificial nutrition, hydration and opioid sedation. An Advance Care Directive helps your Enduring Guardian or any other advocate you have appointed to be able to understand and represent your choices when you can’t.

When does an Advance Care Directive come into effect?

An Advance Care Directive will only be used when you are physically unable to express your medical preferences to your medical team, such as in the case of stroke, dementia, coma or an advanced illness that limits speech.

Who will speak for me if I can’t?

In an Advance Care Directive, you must nominate a ‘substitute decision maker’ (this might also be your Enduring Guardian) to advocate for your choices on your behalf (they have to sign that they agree to the role).  

Is an Advance Care Directive different to Voluntary Assisted Dying?

Yes. An Advance Care Directive allows us to stipulate the types of medical interventions designed to keep our body functioning that we may not want at the end of our life, while Voluntary Assisted Dying is a legal process that can be initiated to actively end a dying person’s life to avoid suffering.

How do I complete an Advance Care Directive?

You need to make some big decisions, so this is the way I recommend you do it.

• Go to www.advancecareplanning.org.au and read everything there is to know on that site, then click on your state/territory and download a booklet, which includes the correct form to fill in.

• Book an appointment with your GP and ask them to explain the consequences of the choices you are considering. They might offer to make an Advance Care Directive on the spot, but I feel it’s good not to rush things, and to use the form I mentioned at Point 1 as it’s quite detailed.

• Fill in your Directive and go over it with your substitute decision maker and get them to sign it. It’s important to explain WHY you are making these choices.

• Take it to your GP and sign it in front of them so they can verify that they believe you have the capacity to understand the choices you’ve made and have made them freely. Make sure you get your own original signed copy back to take home (see below for where to keep it).

Who should know I have an Advance Care Directive?

It’s very important to have conversations with your family, carers and medical team so they understand what you’ve chosen and why. Believe me, it will make the process much easier for them if the time comes that it’s needed.

Where should I keep my Advance Care Directive?

The more people who know about your Advance Care Directive the better, as this will ensure that the medical team is fully aware that you have one.

• You doctor will scan and upload a copy to your medical file, and will upload a copy to your MyHealth Record (if you use that process).

• Make copies of the original and

1. keep the original copy in your ‘Important Papers’ folder;

2. give one copy each to your next-of-kin, Enduring Guardian and/or Substitute Decision maker;

3. if you need to go to hospital for any reason (particularly in an ambulance), always take a copy of your Advance Care Directive with you.

4. if you are tech-savvy, keep a ‘soft’ copy on your phone or computer.

5. keep a card in your wallet (or a note on your phone) that has details of your emergency contacts, substitute decision maker and the name, phone number and address of the GP who signed your Advance Care Directive and holds a copy of it.

Sounds complicated right? But it’s very important if you have a clear idea of what medical interventions you do or don’t want. If you need more information, speak with your GP, phone the Advance Care Planning Support Service on 1300 208582 or go to www.advancecareplanningaustralia.org.au.