Advance Care Planning – are you prepared for the future?

 

More and more people are choosing to prepare an Advance Care Plan that reflects their health goals, values and beliefs, that could be used to make decisions if due to advanced age, illness or cognitive impairment they are unable to make decisions for themselves.

 

The following information from Advance Care Planning Australia, an organisation that is dedicated to educating Australians about all aspects of Advance Care Planning, outlines what you need to consider when thinking about care planning in the future.

 

Why should you think about advance care planning?

 

To make medical decisions, you must have decision-making capacity. If illness or serious injury (temporary or permanent) prevents you from making decisions about your health care, advance care planning makes sure that your values, beliefs and preferences for treatment and care are understood and respected. Completed and accessible Advance Care Directive documentation allows you to be heard and is important to your treating team and others.

 

How to do advance care planning

Advance care planning is an ongoing process with a number of steps.

 

  1. Be open – Think and talk about your values, beliefs and preferences for current and future health care. Choose a substitute decision-maker: someone you trust to speak for you if you became very sick and couldn’t speak for yourself. Ask them if they are prepared to be your substitute decision-maker.
  2. Be ready – Talk about your values, beliefs and preferences with your substitute decision-maker and other people involved in your care such as family, friends, carers and doctors. Write your preferences and/or appoint your substitute decision-maker using the recommended Advance Care Directive document(s).
  3. Be heard – Share your Advance Care Directive documentation with your substitute decision-maker, family, friends, carers and your doctors. This will help ensure everyone knows what you want.
  4. Upload your completed documents to your My Health Record.
  5. Review your plan regularly and update it as needed.

 

Who will speak for you?

 

If you become unable to make decisions about your own health care, a substitute decision-maker will make decisions on your behalf. Your substitute decision-maker may be:

  • Chosen and appointed by you.
  • Appointed for you by a guardianship tribunal.
  • Identified for you by a default list under legislation.

 

Your substitute decision-maker is the first of the following who is available, willing and able to make decisions:

 

  1. An enduring guardian appointed by you.
  2. A guardian appointed by the State Administrative Tribunal to make decisions (full or limited) on your medical treatment.
  3. The first of the following (person responsible):
    1.  Your spouse or de facto partner.
    2. Your nearest adult child.
    3. Your nearest parent.
    4. Your nearest sibling.
    5. Another adult with a close personal relationship to you.

 

Appointing your substitute decision-maker

 

In Western Australia, the substitute decision-maker appointed by you is an enduring guardian or joint enduring guardian.

 

You may want to choose and appoint one or more adults to this role. To do this you need to complete the Enduring Power of Guardianship form. The form has specific requirements for completion and witnessing. Your chosen enduring guardian must accept this role by signing the form.

 

Your enduring guardian can consent to or refuse treatment on your behalf. They must act in accordance with any lawful functions, circumstances and directions contained in the form. They must act in your best interests. They should take your views and preferences into account and make the decision they believe you would make if you could make your own decision. For this reason, it is helpful to talk to them about what is important to you and any preferences you have.

 

Advance Care Directive – preferences for care

 

In Western Australia, your Advance Care Directive is known as an Advance Health Directive. In your Advance Health Directive, you can write:

 

  • An instructional directive with legally binding instructions about future medical treatment you consent to or refuse.
  • Confirm appointment of your enduring guardianship.
  • Medical treatment includes treatment for physical and/or mental conditions. You should use the prescribed Western Australian Advance Health Directive form or substantially similar document. The form has specific instructions for completion that need to be followed. It needs to be witnessed by two adults including a person authorised to witness statutory declarations.

 

Upload your completed Enduring Power of Guardianship form and your Advance Health Directive to your My Health Record.

 

Making changes

 

It is recommended that you review your decisions and documents regularly. This is particularly important if there is a change in your health, personal or living situation. You can update your Advance Health Directive and/or your appointment of an enduring guardian at any time providing you still have decision-making capacity.

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