Advance Care Planning
What is Advance Care Planning?
It’s an important process where individuals discuss their wishes for end of life healthcare with those close to them and/or their healthcare team, in case they become too unwell to make decisions or speak for themselves. Although talking about your wishes is important, some people also write them down using an Advance Health Directive or Statement of Choices Form.
Another important part of Advance Care Planning is giving someone you trust the legal right to make decisions about your healthcare if you’re unable to do so: an Enduring Power of Attorney (EPA). An EPA can be appointed for health or financial matters, or both. If you appoint an EPA it’s important you talk to them about your wishes so they can speak for you in the event you’re unable to.
You can begin the process of Advance Care Planning at any time regardless of whether you have a medical condition. Most people find they need to have more than one conversation with those close to them and/or their healthcare team before they’re ready to write anything down. Starting early is a good idea as it gives you time to learn about your choices and think about what you might want.
Why should people do Advance Care Planning?
Advance Care Planning gives people more control over their healthcare. For people with serious illnesses, having open conversations with family and healthcare professionals about the way they wish to live and be cared for is important.
These conversations help health professionals and families understand a person’s goals and preferences and what an acceptable quality of life is to them. This will allow healthcare professionals and families to make better decisions for a person who is unable to make decisions for themselves.
It’s also beneficial for people to have conversations about the care they want at the end of life while they are well or undergoing treatment, and not just at times of crisis. It can relieve anxiety about the future and provide peace of mind.
When does an Advance Care Plan come into effect?
An Advance Care Plan only comes into effect in the event a person becomes so unwell they lose the ability to make or communicate decisions about their healthcare.
Practical advice for Advance Care Planning
Advance Care Planning documents apply across all healthcare settings (i.e. hospital, GP, community health centres).
If a person with a haematological cancer has completed an Advance Care Plan, it is important they give copies to their family, general practitioner and haematology team at the hospital.
For people who have not appointed an EPA, an individual close to you usually automatically becomes your Statutory Health Attorney because of their relationship with you. By law, it’s the first available and culturally appropriate adult from the following: a spouse or de facto partner (as long as the relationship is close and continuing); a person who is responsible for your primary care, but isn’t a paid professional carer; or a close friend or relative over the age of 18. If you live on your own and don’t have a primary carer, it’s best if you nominate an EPA to avoid difficulties in identifying the appropriate Statutory Health Attorney for you.
Which document is which?
It can vary state by state, but in Queensland a written Advance Care Plan may include one or more of the following forms:
- Enduring Power of Attorney – a legally appointed substitute decision maker for health and/or financial matters. It only comes into effect if you’re unable to make or communicate your own decisions.
- Advance Health Directive – a legal document that states your wishes or directions regarding your future healthcare for various medical conditions. It only comes into effect if you’re unable to make or communicate your own decisions.
- Statement of Choices – a document that states your wishes or directions regarding your future healthcare as well as your individual values that can be used as a guide by substitute decision makers. It only comes into effect if you’re unable to make or communicate your own decisions.
If you’d like to complete an Advance Health Directive, Statement of Choices form, or nominate an Enduring Power of Attorney, speak with your general practitioner or haematologist, and solicitor or the Public Trustee. You may also like to visit the Legal matters section of our website, which gives more information about Wills and an Enduring Power of Attorney.
You may also find the following websites useful:
Advance Care Planning Australia
Powers of Attorney (information for each state in Australia)
QLD Health Advance Care Planning
QLD Government, Power of Attorney and making decisions for others
Respecting patient choices
The Leukaemia Foundation would like to thank the following people for their help in compiling this information:
Elise Button – PhD Candidate, Queensland University of Technology
Acting Nurse Researcher, Cancer Care Services, Royal Brisbane & Women’s Hospital
Allison Lovell – Clinical Nurse Consultant, Palliative and Supportive Care Service, Royal Brisbane and Women’s Hospital