Why advance care planning matters: Making your wishes known

‘Dad* went into hospital with some unexpected cardiac issues. He had done his Will, Power of Attorney and Enduring Guardian paperwork a few years ago, but I was struck by the realisation that we didn’t know what was important to him when it came to dying.  

I remembered having to listen to a doctor ask Mum whether she wanted to be resuscitated if something went wrong just before going into an operating theatre. I didn’t want Dad to have to face those questions moments before going into a serious surgical procedure.’

Advanced care planning involves thinking ahead about what matters most to you and the type of medical care you would want to receive. It gives people the opportunity to communicate to their families, friends and health professionals information about the kind of treatments they’d like to receive if they become unable to make those decisions. 

An Advance Care Directive, sometimes referred to as a “living will”, is a personal document that sets out your preferences for future health care. It generally includes information about your values, beliefs, preferred outcomes and instructions about the treatments you do or do not want. Family members, medical teams or guardians cannot override a valid Advance Care Directive. 

An Advance Care Directive includes preferences for end-of-life treatments such as resuscitation, life support (artificial ventilation) and the administration of life-prolonging medications. It also includes information about whether the person would prefer to be cared for at home, in hospital, or at another location, and the kinds of things that are important to them in making that decision. 

‘I sat down with Dad at the hospital and, using the NSW Health form, spoke to him about his preferences. It wasn’t an easy conversation, but we had a few laughs about his need for quiet spaces and dislike of onion. Talking to Dad about his preferences gave me a clearer understanding of the things that I need to take into consideration if I have to make decisions for him in the future.’ 

NSW Health has produced Making an Advance Care Directive, a resource that provides information on completing a Directive and a form for people wanting to create their own. The resource helps people understand what is required to have a valid directive and when it will be used. For example, it must be created when the person has decision-making capacity. While the document does not need to be witnessed to be valid, it is recommended that it be signed by a health professional who can assess the person’s capacity at the time the directive was completed. 

‘We asked the doctor on duty to sign Dad’s Advance Care Directive. He asked Dad a few questions to check his capacity and then signed the document for us. I was then able to scan it and send it to the hospital for inclusion on his medical records. The staff at the hospital seemed almost relieved that they would have some guidance about his preferences if it was needed. It felt like a good thing to do for everyone involved in his care, and I am reassured knowing he will have his health-related decisions respected.’ 

An Advance Care Directive is an important guidance document. It acts as a roadmap to support family, friends and guardians when making health and lifestyle decisions on a person’s behalf.   

An Advance Care Directive helps guardians by: 

• Providing clear direction about the person's values and preferred outcomes. 

• Assisting guardians to make decisions that align with the person’s wishes, rather than their own views.  

• Supporting consistent communication with hospitals, residential aged care facilities, and treating teams. 

• Ensuring that any choices the person has made, such as consenting to specific treatments or refusing others, are upheld.  

NSW Health provides a range of online resources on advance care planning and offers the National Advance Care Planning Support Service that can be contacted on 1300 208 582. 

If you have any questions about how private guardians can support end-of-life planning, please contact 1300 109 290. 

*Personal details have been omitted for privacy reasons