The new Aged Care Act 2024 (Cth) and Strengthened Aged Care Quality Standards are now in effect, embedding a rights-based approach at the heart of aged care.
The new Aged Care Act 2024 (Cth) and Strengthened Aged Care Quality Standards are now in effect, embedding a rights-based approach at the heart of aged care.
Under the new Statement of Rights, older people receiving aged care are now legally recognised as rights holders. This means providers delivering personal and clinical care, nursing and transition care and residential care (including respite) have a responsibility to actively support advance care planning (ACP) conversations and guide older people through the process of documenting their care preferences, if they wish.
Core principles such as independence, autonomy, empowerment, and freedom of choice are central to the Statement of Rights, and perfectly aligned with the goals of advance care planning.
A rights-based approach to advance care planning
Advance care planning is not simply a compliance task, it’s a meaningful, person-led conversation about what matters most to each individual.
While the new legislation introduces obligations for certain providers to support advance care planning, it’s critical this is not seen as a tick-box exercise. Inviting and supporting ACP conversations should be business as usual, it’s about knowing the person well, understanding their values, and truly hearing their voice.
Advance Care Planning Australia recognises that misconceptions and complexities still surround this area. As the Strengthened Aged Care Quality Standards commence, here are some key reminders for providers and care teams.
1. Advance care planning is voluntary
It’s each person’s choice whether, and how, they engage in advance care planning. Advance care planning looks different for everyone. It may include conversations, nominating a substitute decision-maker, or completing formal documentation. Documents may not be part of the process for some people.
Importantly, advance care planning is not a prerequisite for entering residential care or receiving support at home. The right to plan for future health care also includes the right not to complete advance care planning documents.
2. Use a supported decision-making approach
Wherever possible, support older people to participate in decisions about their care to the full extent they are able.
Some may need help from a family member, friend, or health professional. People living with cognitive impairment, such as dementia or intellectual disability, should not be excluded. Substitute decision-making should only occur as a last resort.
3. Only people with decision-making capacity can complete an advance care directive
Each state and territory has its own recognised forms for documenting future health care preferences.
People with impaired decision-making capacity, such as those with advanced dementia or post-stroke cognitive impairment, cannot legally complete an advance care directive or appoint a substitute decision-maker. Nor can others complete these documents on their behalf. There is an option for people who do not have capacity to have a document about their values and preferences completed by their substitute decision-maker/s to support future decision-making. Some States and Territories have a specific form for this, ACPA also has a Values and Preferences Form - Impaired Decision-making Capacity.
4. Understand the difference between a supporter and a substitute decision-maker
Under the new system, a registered supporter (registered through My Aged Care) helps an older person make decisions, but only with the person’s consent and while they retain decision-making capacity. This role ceases when the older person no longer has capacity.
A substitute decision-maker, on the other hand, makes health care decisions on behalf of a person who no longer has decision-making capacity. They may be formally appointed by the individual or identified according to the legal hierarchy in their state or territory.
5. Advance care planning is an ongoing process
Advance care planning is not “set and forget.” Providers should revisit conversations and documentation regularly, for example, during routine care reviews, following a hospital admission, a significant change in health, or a major life event such as the loss of a partner.
Good advance care planning documents should always reflect a person’s current values and preferences. People can review or update their documents at any time, provided they have decision-making capacity.
6. Advance care directives are only used when the person can’t speak for themselves
The person’s voice must always be front and centre. Advance care directives and a substitute decision-making role are only enacted when an individual no longer has decision-making capacity for the specific healthcare decision at hand.
Learn more
To help your organisation and team prepare for the new rights-based approach to advance care planning:
- Visit the Advance Care Planning Australia website for comprehensive information and resources.
- Explore ACPA’s Learning page for free microlearning campaigns and workforce training.
- Access the ELDAC Quality Improvement toolkits for Home Care and Residential Aged Care to strengthen organisational readiness.
- Read about advance care planning for people who can’t make their own decisions.
- Use Advance Care Planning Australia’s updated document for people with impaired decision making Values and Preferences Form - Impaired Decision-making Capacity.
- Read about aged care considerations in advance care planning Aged care considerations | Advance Care Planning Australia.
- Watch a video on seven common questions about advance care directives in aged care Seven Common Questions about Advance Care Directives in Aged Care.