To effectively communicate values and preferences with others, you must first know and understand these yourself. Use these prompts to help someone start advance care planning and to start considering their beliefs, values and preferences for their current and future health.

It can help them to think about the medical treatment they may or may not want. This is no different to arranging life insurance or a Will. There are no wrong answers to these questions. 

Past experiences of health

• Have any past experiences of healthcare influenced their views on their future care? These may be positive or negative experiences that have happened to them or others.

Current health

• Do they feel they have a good understanding of their current health?
• How does their current health affect their life?

Future health

• What makes life worth living? For example, talking to family.
• What abilities do they need to maintain to preserve their dignity? For example, toileting independently.
• What if they cannot recognise or understand their family?
• What if they cannot eat or drink?
• What if they are not able to talk to their family and friends?
• What if they lost your independence and needed help to do everything?
• What short and long-term goals do they have? For example, attending a birthday, going on a holiday.
• What treatments will help them to live the way they want?
• What would be their minimum acceptable outcome? For example, feed themselves, think for themselves.
• How may their beliefs about religion and spirituality affect their choice of medical treatments?
• Are there any medical treatments that they feel strongly about, either having or not having?

Who should make decisions?

When a person prepares their Advance Care Directive, they may invite someone to be their substitute decision-maker. If the person loses their ability to make their own healthcare decisions, the substitute decision-maker can then make decisions on their behalf.

This may include a:

• partner
• friend
• sibling
• adult child
• parent
• religious advisor
• legal representative.

Download our companion guides, useful to help someone get started with advance care planning.

Talk with the person about their values, beliefs and life goals. Make sure you understand and respect their approach to health care, living well and end-of-life decisions.

If you and the person have conflicting beliefs, be honest with them. Remember that you may be called upon to advocate for them. If your beliefs are too different, it may be better for them to choose someone else.

Talk about any potential issues that may arise with family members or partners who have different views. How will you cope with any disagreement that could arise? If you are chosen as a substitute decision-maker, do they know?

Being chosen as a substitute decision-maker

If someone asks you to be their substitute decision-maker, think about what it might mean for you before you agree. 

Ideally, you need to be: 

• available (live in the same city or region) or readily contactable
• over the age of 18
• prepared to advocate and make decisions clearly and confidently on the person’s behalf when talking to doctors, other health professionals and family members if needed.
• Comfortable with encouraging the person to talk through their preferences with their family members and close friends.

A substitute decision-maker will be asked to make medical treatment decisions on the person's behalf if they are not able to do so. 

A person may also choose a second person (an alternate substitute decision-maker). They will be called on if you are unable to make decisions on the person's behalf. 

Substitute decision-makers may have different titles depending on the Australian state or territory you are in. Some of the other titles used are: 

• Medical Enduring Power of Attorney or Medical Treatment Decision-Maker (Victoria)
• Enduring Guardian (New South Wales, Tasmania, Western Australia)
• Enduring Power of Attorney (Queensland, ACT)
• Substitute Decision-maker (South Australia)
• Decision-maker (Northern Territory).

To formalise the selection of a substitute decision-maker, the relevant form that’s used in the person's state or territory must be completed. This form must be witnessed by someone who can authorise a statutory declaration, for example a: 

• medical practitioner
• legal practitioner.

Encourage the person to write an Advance Care Directive. Find the relevant forms or 'Advance Care Planning and the law' fact sheet, and/or substitute decision-maker documentation for your state or territory.

Ask for a copy of the Advance Care Directive every year and keep it safe. An Advance Care Directive should contain information about the person's values and preferences. As all future circumstances cannot be predicted, this information will help a substitute decision-maker to decide on what they would want. It should also include the name and contact details of the person's substitute decision-maker(s). Familiarise yourself with the person’s preferences and ask them to explain anything that isn’t clear.

Encourage them to review their Advance Care Directive every year or if there is a change in their health or personal situation.

Encourage them to load their Advance Care Directive onto ‘My Health Record’ at myhealthrecord.gov.au

Copies of the person's Advance Care Directive and the form nominating their substitute decision-maker should be given to:

• their family
• their substitute decision-maker
• their hospital and local doctor
• the ambulance service
• anyone else who you feel is appropriate.