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. The plan helps them make decisions that match your values if you can't make decisions yourself.

What is an advance care directive?

Advance care planning involves writing down your values and preferences regarding your future healthcare. This document is called an 'advance care directive', but it has different names in some states and territories.

In most cases:

• this document is legally binding, if you signed it when you had decision making capacity
• your doctor and loved ones cannot override (change) directions stated in your advance care directive

Decision making capacity refers to your ability to make day to day decisions about things like:

• legal matters
• medical and healthcare matters
• financial matters
• personal matters

You don't need a lawyer for your advance care directive to be legal. But you may need witnesses to sign it when you do. It's also a good idea for your substitute decision-maker and your doctor to sign the form.

If you don't have decision making capacity, you can still outline your wishes and preferences in an advance care directive. This isn't legally binding, but it will help your substitute decision-maker and healthcare team know what you want.

Watch this video from ELDAC, End of Life Law for Clinicians and Advance Care Planning Australia on advance care directives in aged care. This resource was developed with funding from the Department of Health, Disability and Ageing.

Video not working? View it here.

What is a substitute decision-maker?

Part of advance care planning involves choosing a substitute decision-maker. This is a person who can legally make decisions about your healthcare for you 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 choose a second substitute decision-maker. This person will help if your first substitute decision-maker cannot make decisions for you.

Who might need an advance care directive?

Everyone can benefit from having an advance care directive that shows what they want, no matter how old they are or how healthy they feel.

It's best to complete an advance care directive when you:

• are still able to communicate
• 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 many health problems
• have a life-limiting illness
• are at risk of dementia or another health problem that may affect your legal capacity

Why is having an advance care directive important?

No one knows what will happen in the future and what health problems they might have.

Advance care planning makes sure your future healthcare matches your values and preferences, even if you can't make decisions yourself. It also helps 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 make sure you don't receive health treatments that you don't want. An example is being put on a ventilator in an intensive care unit.

How do I start advance care planning?

Advance care planning starts with thinking about what you want for your future healthcare. If you haven't thought about this yet, you can learn about palliative and end of life care. Learning about the 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 talk about your values, preferences and plans with your family, friends, carer and healthcare team. This will help them to understand what you want for your healthcare. It can also help you decide what you want if you aren't sure.

Most people find it difficult and upsetting to talk about being very sick or dying. The Australian Government Department of Health, Disability and Ageing has some tips to help you start the conversation.

How do I create an advance care directive?

The way to make an advance care directive is a little different depending on the state or territory where live. Different states and territories have different documents to fill out.

Visit Advance Care Planning Australia to create a document that follows your state or territory's regulations.

After you make your advance care planning documents, it's a good idea to upload your documents to your My Health Record. This way, your doctors can see them if they need to.

Resources and support

The Department of Health, Disability and Ageing has information and resources about the parts of advance care planning.

Advance Care Planning Australia has:

• a range of resources about advance care planning and links to the relevant documents for each state and territory.
• information about advance care planning in languages other than English.

ELDAC has an end of life law tool kit for consumers and for clinicians to help you deal with common legal issues.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.