What is an Advance Care Directive?

Next to your Will, an Advance Care Directive is one of your most important medical documents.

Last updated: November 29th 2022

An Advance Care Directive outlines your wishes for care if you lose the ability to make, or express, decisions for yourself. [Source: Shutterstock]

Key points:

An Advance Care Directive can provide you chose about how you receive medical treatment after you can no longer make those decisions
Have a trusted family member handle your Advance Care Directive wishes
Advance Care Directives are only advisory, in some instances, they may not be followed

It outlines your wishes for care if you lose the ability to make, or express, decisions for yourself.

Advance Care Directives, or ACDs, are becoming more popular with older Australians because it provides you with the ability to make choices about your future care if you lose the capacity to make those choices later on. It is never too early to document your wishes in an Advance Care Directive.

The use of your Advance Care Directive can be temporary, for example, if you become ill, or it could become permanent, like if you developed a neurodegenerative disease like dementia.

An Advance Care Directive is also an important planning document in preparation for your end of life care.

What does it contain?

Your Advance Care Directive can contain your future health care decisions, end of life care wishes, residential or living arrangements and any other personal matters you want to implement if you are no longer able to make these decisions yourself.

For instance, many people are scared to be resuscitated if they have a heart attack because of what damage or condition they could be left in afterwards. It is not unusual to have a ‘do not resuscitate’ direction in your Advance Care Directive to stop this eventuating.

If you decide not to highlight your wishes in an Advance Care Directive, you can instead appoint a substitute decision maker (or a representative with a similar title) to act on your behalf.

Choose a close family member or friend you trust to make the decisions you want. You should have an open and transparent conversation with the chosen person about your wishes.

Any concerns they may have can be answered and you can be assured that your wishes will be followed as closely as possible.

Implementation of your Advance Care Directive

Keep in mind, your Advance Care Directive is only advisory in some States and Territories, unlike a Will, which is legally binding.

Your documents will generally be followed unless they cannot be adhered to in a particular situation.

Your substitute decision maker, or medical staff, will use your Directive as a guide to provide the care you want.

Generally, an Advance Care Directive document covers lifestyle or care-related wishes, it is not for financial decisions. Any financial decisions can only be made by a Financial Enduring Power of Attorney or a financial administrator.

Also, be aware that your Advance Care Directive will trump other documents you have, like the Enduring Power of Guardianship or Medical Power of Attorney.

An Enduring Power of Guardianship makes decisions about a person’s lifestyle and treatment, also known as an Enduring Guardian. Whereas a Medical Power of Attorney has authority over medical decisions for a person who has lost capacity.

If you want to update your Advance Care Directive, make sure to provide a new version to everyone you gave the original document to.

An Advance Care Directive should be provided to a close family member, your substitute decision-maker, doctor and other health practitioners, and on file with your hospital or aged care facility.

Do not keep your Advance Care Directive with your Will, as it will only be found once you have died.

If you have a Government My Health Record, it may be a good idea to add it to your personal account so medical professionals and doctors have access to the documents.

You can add an expiry date to your Advance Care Directive, indicating that the documents are no longer valid after this date.

For example, you could set an expiry date for every two years, so you can continuously keep updating your Advance Care Directive as your needs change.

ACD differences between States and Territories

If you move to another State or Territory, update your Advance Care Directive to fit within the legislation of that State or Territory. Each State and Territory has slightly different laws around Advance Care Directives.

For instance, in the Australian Capital Territory, the document is not called an Advance Care Directive, it is a Health Direction. Similar to this, your substitute decision-maker in the ACT is called an Attorney.

Substitute decision-makers have different names depending on the State or Territory.

South Australia is the only State to use the substitute decision-maker title.

Queensland calls their substitute decision makers an attorney, and Northern Territory uses the term, decision makers.

In Victoria, your substitute decision-maker is called a medical treatment decision-maker and must sign the form to undertake the role.

While in New South Wales, Western Australia and Tasmania, your substitute decision-maker is an enduring guardian.

In Tasmania, the form has to be registered with the Guardianship Administration Board or it will not be legally binding.

Your chosen decision-maker needs to agree to the role by signing the Advance Care Directive. In some States and Territories, there is a requirement for a witness of the signing.

If you are holidaying in another State or Territory and there is a medical emergency, your Advance Care Directive should be valid to an extent. There may be limitations on some of the decisions within your Directive.

Before travelling, call your Office of the Public Advocate, or equivalent depending on the State or Territory, to get advice before you travel and take a copy of your Advance Care Directive with you.

For information on organising your Advance Care Directive for different States and Territories, head to the Advance Care Planning Australia website here.

What do you want to outline in your own Advance Care Directive? Tell us what’s important to you when receiving health care down below.