An advance care directive (ACD) is an important part of your end-of-life care it:
- formalises your advance care plan
- can contain all your needs, values and preferences for your future care and details of a substitute decision-maker
- is used by your medical decision maker after you are no longer able to make decisions for yourself
- is often referred to as a living will
The directive is a formal version of your advance care plan and outlines your preferences for your future care in line with your beliefs, values and goals. Having an advance care directive means you can also formally appoint a substitute decision-maker for when you can no longer make decisions yourself.
ACD’s differ between states and territories. Some state and territory governments have specific forms that you can use.
Why is an advance care directive important?
Making an ACD is an important part of advance care planning.
It is impossible to know what will happen in the future concerning your health. And you might have firm ideas about how you want to live the rest of your life.
In a crisis your loved ones may find it difficult to decide what treatment is best for you. An ACD will help everyone know what you would want if you can’t tell them.
How to make an advance care directive
You can only make a valid ACD if you are over 18 and have decision making capacity. Decision making capacity refers to a person’s ability to make day to day decisions about things like:
- legal matters
- medical/health care matters
- financial matters
- personal matters
Health professionals and family members must follow a valid directive. They cannot override it.
You should speak with your doctor who should provide you with information and advice regarding your current health situation. We recommend discussing your ACD with your doctor.
An advance care directive can include one or more of the following:
- the person you would like to be your substitute decision-maker
- details of what is important to you, such as your values, life goals and preferred outcomes
- the treatments and care you would like or would refuse if you have a life-threatening illness or injury
Once you have written your ACD, you need to sign it in accordance with the requirements set out in the ACD itself.
You should then give copies of your directive to:
- your family
- your substitute decision-maker
- your hospital and doctor
- the ambulance service
- anyone else who you feel is appropriate
How to select a substitute decision-maker
Choosing your substitute decision-maker is important. It is a good idea to think carefully about who you want to take that role. Your decision-maker will make decisions about your medical treatment if you can’t.
Your substitute decision-maker should be somebody:
- you trust
- who is over 18 years
- who will listen to your values and preferences for future care
- who will be comfortable making decisions in difficult situations
You should ask yourself the question: ‘Am I confident this person will make decisions based on what I would want?’
You can also choose a second person as an alternate decision-maker. They will step in if your first decision-maker is unable to make decisions on your behalf.
In different Australian states and territories substitute, decision-makers may have different titles.
If you want to formalise your choice of a substitute decision-maker, you need to complete the relevant form that’s used in your state or territory.
Uploading your advance care directive to My Health Record
You can add your advance care directive to your My Health Record. That way it’s available to your treating doctors if ever needed. You can also store the names of people you have shared your directive with.
Changing your advance care directive
You can change your Advance Care Directive at any time. If you do change it, make sure anyone you gave the original directive to gets the new version. The most recent version of your directive will be the one followed.
You should review your advance care directive:
- when your preferences change
- if your substitute decision-maker changes
- when your medical condition changes