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What is advance care planning?

The information on this page is reproduced with permission from Austin Health's Respecting Patient Choices Program.

Planning for the future

Take time to consider…

Imagine the following:

• You are in a road accident and you suffer a severe brain injury which leaves you permanently unconscious. You have no awareness of your environment, yourself or other people and you are reliant on others for all your needs. It is not expected that you will regain consciousness; but with full time nursing care you will be kept alive for an indefinite period of time.
  or
• You are diagnosed with severe dementia from Alzheimer's Disease - a progressive disease of the brain, affecting your thinking and behavior. This means that you are likely not to be able to recognise your family, understand what happens to you, or communicate the treatment you want if you developed a serious illness.
  or
• You are in hospital with incurable cancer and your heart stops beating (cardiac arrest)

Think about the benefits and burdens of treatments in these situations and whether certain treatments would be worthwhile to you or you think they would be overly burdensome.

If something like this happens it is helpful for your family and the doctors and nurses to know your values in life, and your attitudes towards medical treatment.

There may be some circumstances where you would want all the treatments that can possibly be offered to you. In other cases, you may feel strongly about not having certain treatments like tube feeding, a breathing machine, antibiotics, blood transfusion, dialysis or cardiac massage.

These are the sorts of things to talk to your family about, to help them make decisions in your best interests if a time came when you were unable to decide for yourself.

What is advance care planning?

You have the right to have a say in your health care, now and for the future. Making decisions about your future medical treatment is called advance care planning.

Advance care planning is thinking about and discussing with the important people in your life and your carers in advance what medical treatments you would and would not want if you were unable to communicate or make medical decisions and were seriously ill, had an accident or were dying

Advance care planning takes into account your current health condition, your beliefs, values and goals and what is important to your life to “live well”. It is an ongoing process that includes:

• Understanding your current health condition, what could happen in the future and what options and choices you have
• Reflecting on your values, beliefs and goals in life
• Considering the benefits and burdens of treatment options and what treatment you would regard as worthwhile and what treatment as overly burdensome
• Discussing all of this with your family/the important people in your life and your doctor and carers – with the people who will be caring for you and having make to decisions for you if you are unable to communicate
• Formulating a plan called an Advance Care Plan to document what has been discussed.

We all eventually need to plan for how we want to live at the end of our lives. Advance care planning enables you to clarify your values and choices and gives your family, doctors and nurses the opportunity to respect your choices. Your doctor or the Respecting Patient Choices Consultant can help you with this.

Why plan in advance?

Planning your care, in advance of any problems occurring, gives those who will be caring for you the opportunity to respect your choices. If, in the future, you become unable to express your choices for treatment, your doctors and family/significant others may not know what you would want and this could be difficult for them. Discussing your choices now can be a comfort to you now and a comfort to your family/significant others in the future.

An Advance Care Plan gives you the opportunity to record your choices ahead of time. An Advance Care Plan ONLY comes into effect if you lose legal capacity to make decisions about your medical treatment.

Advance care planning means talking about what you want.

Think about the treatment you would want and talk about it with your family/ significant others and your doctor. It may be hard for you to face some of the questions and information, but thinking about the medical treatment that is important to you is no different to putting thought into your life insurance, your will or planning for many aspects of your future.

Talking about these things with your family/significant others may not be easy for them because many people are uncomfortable talking about a time in the future when you may be unwell. However, this planning becomes especially relevant if you are seriously ill and cannot make decisions yourself. Effective planning is the best way to make sure that your family/significant others and the doctors and nurses caring for you respect your wishes.

Advance care planning is writing down your choices.

An Advance Care Plan is one way of putting your plan into writing. The written Advance Care Plan helps people to accurately remember what you want and makes it easier to communicate these wishes to doctors and nurses who do not know you. It includes appointing a Medical Enduring Power of Attorney and a statement of your choices.

Publication Date: 23 April 2007