ADVANCE CARE DIRECTIVE

How do you make an advance care directive?

A person is eligible to make an advance care directive only if they are over 18 years of age and have decision-making capacity, which refers to your capacity to make general personal decisions about important lifestyle and healthcare matters such as legal issues, medical and health care decisions, financial issues and other personal matters.

While an advanced care directive does not need to be completed with the help of a lawyer, it is usually advisable to engage with a lawyer in order to ensure that the directive achieves the result you wish to achieve.

The first step is to speak to a healthcare professional who is able to provide you with formal advice about what your current medical treatment needs are, as well as the potential future health care needs might be.

Generally, advanced care directives will include any of the following specific directives which will determine who is able to make decisions on your behalf, and what kinds of decisions can be made:

• the person (usually a loved one, family member or close friend) who you would like to appoint as your substitute decision-maker;
• anything which might be important to you that might inform how you would make the relevant decisions for yourself (i.e. your personal values, goals and preferences); as well as
• details of any treatment or care that you wish to receive, or would refuse, in the event of any life-threatening illness or injury (such as a “do not resuscitate” directive).

Advance Care Planning Australia has a number of forms and fact sheets available on their website, including an Advance Care Directive Form, which will assist with the development and drafting of a directive. Once the directive has been completed (including your signature and date of the document), relevant parties such as your substitute decision-maker and your doctor should also sign the document itself. This will create a valid advanced care directive that is a legal document and enforceable at law.

It is worth providing copies of the document itself to anybody you feel appropriate, including family members, carers, the substitute decision maker, any relevant healthcare providers such as your hospital, GP, medical professionals, the relevant State Department of Health, and the ambulance service.

Can I change an advance care directive?

You are able to change an advance care directive at any time, and a directive may also be subject to revocation if you no longer require it. It is in fact encouraged that you review the contents of any directive on an ongoing basis, in order to ensure that your goals, values, preferences, health information, as well as your substitute decision-maker and medical treatment requirements are still accurately serviced by the document itself.

How do I choose a substitute decision-maker?

Choosing a substitute decision maker is central to ensuring your advance directive is effective and services your needs, given that person will be able to make important personal decisions on your behalf. Ideally, the decision-maker should be a carer, loved one or family member who is over the age of 18 who you trust. That person must also be available to you and listen to your needs as they might evolve over time.

Importantly, that person must also be comfortable with making significant, often very difficult decisions about your treatment and future health care.

In some circumstance, it may be worth appointing a second substitute-decision maker who will be able to make decisions in circumstances where your primary substitute decision-maker is unable to do so.

The appointment of a substitute decision-maker will be done by filling out the relevant form. This form will differ based on the Australian State or Territory in which you live.