Advance care planning is a process that ensures your wishes regarding your health and care needs are known should you become incapacitated and unable to speak for yourself. Advance care planning informs decision-making by doctors, family and friends.
Advance care planning (ACP) allows you to express your values, beliefs and preferences for your health and care needs while you are well enough to do so. ACP guides decision-making by others in the event you are incapacitated, such as through serious injury or illness.
ACP can commence with a discussion with a general practitioner (GP) or other health care professional. This will assist you to understand your likely or possible health care needs into the future and can ensure your wishes are expressed in a way that can be understood by treating clinicians. State and territory health departments and other specialist organisations offer advice and assistance with advance care planning, either in person or online. Links to national and state-based ACP services and resources are listed below. While the specifics of ACP are informed by relevant legislation in states and territories, advance care plans prepared in one jurisdiction are generally accepted by other jurisdictions.
Importantly, an Advance Care Plan is not just about dying; it’s also about how you would like to live. Medical decisions aren’t just about if you live or die; they may be about whether you die, or recover fully, or make a partial recovery and require a level of medical or personal support either temporarily or from that moment on.
Advance Care Planning is something we all know we should do, but so often it’s left to the bottom of the pile.
There are a lot of terms, processes and concepts that can all get mixed up in this space. Advance Care Directives, Living Will, Last Will and Testament, Enduring Power of Attorney, Enduring Guardian, Statement of Choices, Health Direction – it can be confusing. So let’s clear up what’s what.
Advance Care Planning is the process for recording your choices and preferences for your health care if you’re unable to communicate those yourself. It doesn’t cover financial matters, property matters or any other legal responsibility, Good Advance Care Planning will help you consider questions like:
- What kind of care would you like, or choose to refuse?
- What outcomes are acceptable to you as a result of medical care?
- Who would you like to make decisions for you if you can’t make them for yourself?
- Where would you like to be cared for if you were dying?
Resources
ACT Health’s Advance Care Planning
NSW Health’s booklet ‘Making an Advance Care Directive’
In NSW, there is no formal form like there is in the ACT. You can handwrite it or type it, as long as:
- you have capacity to make your own decisions when you write it
- it is clear and specific about medical treatments that you do and don’t want
- it reflects your preferences and nobody else’s
- it applies to the situation you are in at the time.
In NSW, if you want to assign somebody to be your substitute decision maker you need to appoint an Enduring Guardian. This role is only for matters of health and lifestyle.
What about a living will?
Living will is a term that is more often used in the US and other countries for a similar process to Advance Care Planning, but it’s not used in the ACT or NSW. Your Last Will and Testament only comes into effect once you’ve actually died; it has no legal implications for your care while you’re still alive. So any directions for your care while you’re still alive need to happen through the processes and documents mentioned above.
Who should do Advance Care Planning?
Everyone over the age of eighteen with decision-making capacity! It might feel too far off for a younger person to worry about, but sudden accidents or unexpected illness can happen to anyone. It’s an enormous help to your family if they’re being asked to make life-altering or life and death decisions for you. For example would you want to be resuscitated if the likely best-case outcome was Scenario A, but not if it was Scenario B? If your family knows what you want, you’re more likely to get that outcome.
How often do I need to refresh my Advance Care Planning?
Once it’s done, many people breathe a big sigh of relief. But that doesn’t mean it should be over. Life can change, and the medical and care decisions you make when you’re fifty might look very different from when you’re eighty. You should consider whether any of your advance care planning might need to change if:
- Your base level of health changes, either for the better or the worse
- Your personal situation (e.g. work, home arrangements, family support) changes
- Your substitute decision maker is no longer available (e.g. they move to another city)
Who can help me do my Advance Care Planning?
The ACT has an Advance Care Planning team as part of their health department. You can call them (02 5124 9274), or email them ([email protected]), and they will take you through the whole process.
In other states and territories, your local council or health service may have recommendations for support in your area.
The National Advance Care Planning Support Service can be contacted on 1300 208 582 for more information and advice, or you can email them on [email protected].
Key takeaways
- Advance Care Planning is for everyone
- Know what the recommended documents are in your local area.
- Support is available to help you complete this planning
- Keep it updated as your needs change