Published on: 10th February 2025
Advance Care Planning: Thinking Ahead Before Something Happens
This guide discusses Advance Care Planning (ACP). It will cover what an ACP is, how to decide on what’s important to you, and tips on picking a person who will represent your wishes.
Advance Care Planning means thinking about, discussing, and writing down your preferences and values when it comes to your health and the care you receive. An Advance Care Plan tells people how you want to be treated and cared for, in case something happens, and you are not able to tell them yourself.
Everyone should think about ACP – it’s not just for people who are old or sick, it’s about thinking ahead and having a plan before something happens.
Think of Advance Care Planning a bit like insurance – you hope you never need it but it’s good to know it’s there in case you do! The other good thing about having conversations with your family and friends is that it helps you understand what’s important to each other.
Some questions you should think about, include:
- What if you had to make decisions for someone – would you know what they want?
- Who knows what you want?
- Who would you want to communicate your preferences and what would you want them to say?
Your Advance Care Plan is a plan or guide for other people to follow in case they need to make healthcare decisions for you, because, for some reason, you can’t make them for yourself. Being unable to make decisions or communicate decisions could be:
- Temporary, if you were very sick and you will get better
- Permanent – if you had a stroke or bad accident
It could also be when you are at the end of your life.
When you CAN communicate or make decisions – health care workers HAVE to follow them. Advance Care Plans are only used when you CANNOT make or communicate decisions for yourself.
An Advance Care Plan helps you to get the care that you want. There is much less stress and worry for families and more satisfaction with care. Everyone has the direction they need to make decisions.
When people have not made their health care preferences clear or decided on a decision maker, health care workers will have to make decisions based on what they think is in the person’s best interest, which might include things that you do not want.
Many people find it hard to think about and talk about their future – don’t worry – there are tools and people that can help you. Remember too that Advance Care Planning is voluntary – it’s up to you whether you want to want to think about putting a plan in place for your future.
Who would communicate your decisions for you?
Ideally the person or people who you choose to communicate your wishes for you is someone who you trust and who you have told what’s important to you. They understand and respect your approach to health care and what living well means to you.
They should also be over 18 years old and comfortable to make decisions in difficult circumstances. They could be your partner, friend, brother/sister, parents, adult children, someone from your church or a neighbour. You could consider appointing more than one person in case that one person is not available when you need them.
What would you want them to say?
For others to be able to act and communicate for you, they must know and understand you and your beliefs, values and preferences.
To help you talk about this you should first think about the medical treatment that you would want or would never want to receive.
Consider the experience of someone else who was sick. How easy or hard would it have been for you to know what they wanted. What would have been helpful for you to know, so that you could have helped them.
How is your current health and how does it affect your life, what do you see happening in the future? What makes life worth living – what kind of things bring you joy, peace or pleasure – family, friends, pets, independence, being spontaneous.
Looking into the future, what kind of things would you never want to experience? For example, machines keeping you alive, not being able to feed yourself or go to the toilet alone, relying on others for everything. Are there medical treatments that you feel strongly about – ICU, ventilation, CPR. These are sometimes called life-prolonging treatments and whether they bring benefit or burden is based on the individual person and their circumstances. Which treatments would you object to and in what circumstances. Are there religious or cultural beliefs that need to be considered?
Starting the Conversation
Having meaningful conversations with your loved ones is the most important part of advance care planning. These tips and resources that can help you to start the conversation. For example, you can:
- Use conversation starters, such as articles, TV shows, movies, or current events, that relate to health care or end-of-life issues.
- Share what matters most to you, such as your values, beliefs, goals, and fears, and ask your family to do the same.
- Ask your family who they would trust to make decisions for them if they were unable to do so and tell them who you would choose as your health decision maker.
You don’t need to talk about everything all at once, and you don’t need to agree on everything. The most important thing is to start the conversation and keep it going. Advance care planning is an ongoing process, not a one-time event.
So after you’ve thought about what decisions that you’d want made AND you’ve decided who would speak for you if you couldn’t yourself, the next step, to formalise Advance Care Planning, is to turn those words, conversations and decisions into documents – legal documents which assign power to other people to make decisions on your behalf and documents which describe what you value most in healthcare and life.
Have the Conversation, Start Writing Your Plan
ACP starts with thinking and discussing the best way to make sure that your wishes are respected. But the best way to ensure these are followed is to write it down. There are some official Advance Care Planning documents, and these are different depending on where you live. That is because the states and territories have different laws.
These documents provide information about your health care choices, what is important to you – what sort of care or treatment that you would or would not want, as well as telling doctors and nurses who to speak to about you – your decision maker.
What are the Documents or Forms?
Each state and territory have documents that are recognised under the law.
Individual state or territory documents may have slightly different names, functions and witnessing requirements.
Make sure that you use the correct document, which is recognised under the state/territory you are in.
What happens with the Documents after they’re completed?
It’s important that your documents are available for your decision makers, the people who might be caring for you (doctors, nurses, ambulance, care facilities) as well as being current. These documents should be reviewed often to ensure they still reflect your wishes, and your decision makers are still the people you would choose today. Make sure they have a copy.
So, be prepared for life and put an Advance Care Plan in place. Think about, talk about and tell people what’s important to you in terms of your healthcare – and then write it down.
Resources:
