Advance Care Planning

Advance care planning is important for everyone.

It involves you, your loved ones and health professionals talking about your values and the type of health care you would want to receive if you became seriously ill or injured and were unable to say what you want.

Ideally these conversations start when you are well and continue throughout your illness.

Your wishes should be documented to help your loved ones and health professionals when making decisions about your care when you are no longer able to do so. Please remember to bring the documentation when you come into hospital.

For more information and feedback on content of webpage:
seslhd-clinicalstreams@health.nsw.gov.au 

Advance Care Planning information: 

NSW Health 

NSW Trustee and Guardian

My Health Record 
Using My Health Record to store advance care planning documents

Advance Care Planning Australia 

SESLHD Advance Care Planning Clinical Redesign Project - ACI Innovation Exchange

When should an advance care plan be done?
It is never too early to plan ahead.

Opportunities for advance care planning discussions can arise following a new diagnosis of health condition, changes in health status or changes to treatment plans or if there is a change in personal or living situations. Advance care planning documentation can be accessed and updated by the person at any time and it is important to keep it up to date.

Is advance care planning only relevant to palliative care?
Everyone should consider advance care planning, regardless of age or health. Ideally, planning should start when people are well - before there's an urgent need.
It is particularly important for people who are:

  • older
  • have a chronic illness
  • have multiple diseases
  • have an early cognitive impairment
  • are approaching the end of life

Is there a formal template I need to use in NSW?
In NSW, there are two ways you can record your choices for future medical care:

  1. Appoint an enduring guardian
  2. Complete an Advance Care Directive 

When you appoint an enduring guardian, you are choosing a trusted relative or friend to manage your health care. The person you appoint becomes your substitute decision-maker if you are no longer able to make decisions. This decision can also be revoked at any time. For more information, refer to Advance Care Planning Australia

An Advance Care Directive records your specific preferences for future health care. This includes treatments you would accept or refuse if you had a life-threatening illness or injury and will only be used if you do not have capacity to make decisions for yourself or to communicate your preferences. In NSW there is no specific form or template. Preferences can be simply written down, dated and signed. However NSW Health has created an Advance Care Directive form that can make the process of completing an Advance Care Directive easier.

Can someone access voluntary assisted dying because it is documented in their advance care directive?
To access voluntary assisted dying, the person must retain decision-making capacity and the ability to communicate requests and decisions throughout the entire process. Because an advance care directive only comes into effect when the person no longer has capacity, voluntary assisted dying cannot be accessed by requesting it in an advance care directive.

How and when are advance care planning documents used by healthcare professionals?
Advance care directives and plans will only be used if you do not have capacity to make decisions for yourself or to communicate your preferences for healthcare and treatment. An advance care directive is legally binding, an advance care plan is not.

Where do I go to seek support to create an advance care plan?
Please ask your treating doctor or GP for assistance. Alternatively, Advance Care Planning Australia provide a support service. For free advice or to request a printed starter pack, call Advance Care Planning Australia on 1300 208 582 from 9am - 5pm (AEST) Monday to Friday. 

Where do I store my advance care plan or directive?
It is recommended that the documents are shared with trusted contacts and uploaded to My Health Record. You might also choose to have your documents uploaded into the hospital electronic medical records. Please ask the hospital staff how this is undertaken.

Do advance care directives expire?
Unless they are revoked, advance care directives do not expire. If you change your advance care directive, you should make sure you let people know and replace all of the copies with a new advance care directive.