Advance care planning allows health professionals to understand and respect a person's future healthcare preferences, for a time when they become seriously ill and unable to communicate for themselves.
All healthcare professionals and aged care workers have an important role to help with planning and ensuring people have choice in their care. You might want to start the conversation with someone, or they might ask you about the requirements of advance care planning.
Ideally, advance care planning will result in a person's preferences being documented into an advance care directive to help ensure these preferences are respected.
When to introduce advance care planning
Advance care planning conversations should be routine and occur as part of a person’s ongoing healthcare plan. Better outcomes are experienced when advance care planning is introduced early as part of ongoing care rather than in reaction to a decline in condition or a crisis situation.
Read more about triggers for introducing advance care planning and starting the conversation.
Explain to patients they will need to select a substitute decision-maker(s). This should be someone who is not a paid carer or healthcare provider. Ideally, they will need to be:
- available (live in the same city or region)
- over the age of 18
- prepared to advocate and make decisions clearly and confidently on a person’s behalf when talking to doctors, other health professionals and family members if needed
Learn more about the responsibilities of substitute decision-makers.
Encourage patients to document their plan
After discussing advance care planning with patients, encourage them to document their plan. The processes and names of the relevant documents vary between different states and territories.
Learn more about the process and requirements in your state or territory.
Completing these documents is the best way for people to make their preferences known about the type of treatment they would want if they are unable to participate in decisions and to inform health professionals of these preferences.
Encourage patients to share copies of the documents with their substitute decision-maker, family, friends, carers and relevant health professionals. They should also upload the documents to My Health Record.
Consider the different needs of patients
Australia has a large population with different needs, based on their values, religion, beliefs and preferences. It's important to ensure people receive care that is consistent with these needs.
Culturally and linguistically diverse people
Australia has a rich cultural diversity, with over 300 languages spoken, over 100 religions and nearly 200 countries of origin represented. With these diverse backgrounds come diverse values, some of which may affect an individual’s propensity to engage in advance care planning conversations.
Some aspects of advance care planning may conflict with traditional values expressed by some cultures. But people of all cultural backgrounds may engage in advance care planning.
Start the conversation by asking about the person's beliefs and discussing values with the family. Ask the person if they have any special needs, and involve spiritual leaders in these conversations if the person chooses. Be mindful of the fact that religious and cultural beliefs can differ between families, communities and even individuals.
It's important to avoid cultural assumptions when approaching an advance care planning conversation with patients.
A person’s preferred language is another factor to consider. See our information in a range of languages.
Aboriginal and Torres Strait Islander people
Many Aboriginal and Torres Strait Islander people do not engage in discussions about future medical care and advance care planning. Some may consider discussions about becoming sick or injured, or what will happen towards the end of their life, as ‘family business’ that is not to be discussed with others.
Learn more about considerations for advance care planning with Aboriginal and Torres Strait Islander people.
Lesbian, gay, bisexual, transgender and intersex (LGBTI) people
People identifying as LGBTI people may have special requirements that should be considered when discussing advance care planning. They may not be in close contact with their family, may have no children or may have family who do not respect their life decisions or partner.
Their partner or the person they want to make medical decisions on their behalf may not be recognised as their substitute decision-maker. Encouraging them to appoint a substitute decision-maker and to document their treatment preferences may be helpful.
People with intellectual disability
Many people with intellectual disability have a limited understanding about death and planning for the end of life. However, given the opportunity, most people with intellectual disability want to talk about these things. As with anybody, these conversations can be uncomfortable but with the right support, they can participate in advance care planning conversations without distress.
Talking End of Life is a great source of information for how to teach people with intellectual disability about end of life.
Training and education
Undertaking training and education is the best way to improve your knowledge and confidence to have advance care planning conversations. We support health professionals to learn about advance care planning through a range of online courses, workshops, webinars and information sessions.
Legal and ethical considerations
As a health professional, it's important you understand the laws and ethical principles of advance care planning.
We also recommend signing up to our newsletter to stay up to date with legislative or process changes.
Responsibilities for healthcare settings
Different healthcare providers have unique responsibilities when it comes to advance care planning.
We produce a range of printable resources for health professionals. They are designed to be given to patients, shared with colleagues or displayed in your office.
For more printable resources, see our range of support materials available to print or order.