Advance care plans: Why everyone should have one

Death and dying is still a taboo topic for many people, but if you have a clear idea of the sort of medical treatment you want towards the end of life then an advance care directive is an essential document.

An advance care directive – also known as a living will or advance care plan – is a document that is only used when you are unable to make your own decisions and express your wishes. It enables you to convey the type of healthcare and life-prolonging treatment you would be willing to receive in the event of serious illness or injury.

Who should consider an advance care directive?

Advance care planning is particularly important for people who are older or frail or for those with a chronic illness, but old age isn’t the only time you may need to rely on someone you trust to make decisions about your medical treatment on your behalf.

As highlighted by the rapid onset of COVID-19, people of any age can become critically unwell. As research shows that 85% of people die after chronic illness and not as the result of sudden death, most people will benefit from thinking about the sort of care they want during that illness and towards the end of life.

Life-prolonging treatments keep organs functioning when you might otherwise die without them. They include intravenous antibiotics to stop infection, breathing tubes and support, resuscitation such as CPR, dialysis to support kidney function and nutritional support through tube feeding.

Why is an advance care plan necessary?

It is not enough for family members to think they know what their loved ones want when they are approaching their end of life. Nor is it enough for you to assume your family or a trusted individual will know what healthcare decisions to make.

Your wishes must be documented in a format that is recognised by a range of health professionals and key decisionmakers. It might include care providers or your GP or treating specialists at a hospital.

Families without a clear path to guide their decision-making often feel burdened by the concern that they will make a wrong choice.

This is where an advance care directive can be invaluable.

What does an advance care directive look like?

There is no national advance care planning legislation in Australia, so the requirements and forms for writing advance care directives and appointing substitute decisionmakers vary between and states and territories.