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Advance Care Planning in WA

More than 80% per cent of Australians think it is important to put our end-of-life care treatment preferences into writing, but less than 5% of us have completed an advance care plan.

Advance care planning is the process of discussing and documenting your future health care wishes, values and priorities. It enables your doctors, friends, family and carers to understand what you want, should you become so unwell that you are unable to speak for yourself.

What is involved in advance care planning?

There are many components of advance care planning, which all help to make sure your wishes are known. They include:

* Reflecting on your values and priorities and what is important to you for the last stage of life.

* Having conversations about your wishes and preferences with family, friends, your GP and other caregivers.

* Understanding what palliative care can provide as well as other possible treatment choices at end-of-life.

* Writing a will.

* Considering organ and tissue donation.

* Completing an Advance Care Plan, and Enduring Power of Attorney and an Advance Health Directive, which are all explained in detail below.

It is important to allow adequate time for advance care planning, as you will need to reflect on what is important to you, discuss it with your doctor and people close to you, and document it. The process can be ongoing, as your opinions, wishes and circumstances may change. To learn more, attend one of Palliative Care WA’s Advance Care Planning Community Workshops.

Documents used for advance care planning

The advance care planning process varies from state to state. In WA, three documents are used to complete the process, two of which are legally binding.

Decisions outlined within these documents only come into effect if you are unable to make or communicate decisions for yourself.

1.  Advance Care Plan

An Advance Care Plan is not a legally binding document, but it is taken into account when care decisions are made on a patient’s behalf. It is used to record wishes that aren’t explained on your Enduring Power of Guardianship form, or in your Advance Health Directive.

This might include where you would prefer to receive care (maybe at home, or in a hospital), who you would like to look after your pets, whether you wish to donate organs and religious or spiritual beliefs relevant to your care.

The Dying to Talk Discussion Starter and My Values website are two resources designed to make discussing end-of-life wishes easier. They walk you through a series of steps as you reflect on your values and preferences and enable you to record and share your wishes.

The WA Cancer and Palliative Care Network and WA Health Department have also produced an Advance Care Plan form, which is designed to be used in conjunction with the Advance Care Planning – a Patient’s Guide.

Doctors and enduring guardians only rely on an Advance Care Plan to make decisions when a patient becomes so unwell that they cannot make and communicate decisions for themselves.

2.  Enduring Power of Guardianship

In WA an enduring guardian is the person you legally appoint to make personal, lifestyle and treatment decisions on your behalf, should you no longer be able to make or express reasonable judgements for yourself.

To appoint an enduring guardian, you need to complete an Enduring Power of Guardianship form. The person you nominate must accept their role. As a legal document, your signature and theirs must be witnessed.

You can limit the scope of your enduring guardian’s decision-making authority, so that it includes, for instance, just treatment decisions. You can also extend it to cover lifestyle decisions, like where you will live.

The form also enables you to give directions for your enduring guardian to follow, such as the medical professionals you want included in your care, and family members you may want to contribute to decision making about your care.

The Enduring Power of Guardianship form has a section where you can indicate that you have also made an Advance Care Directive (see below), to ensure the documents are considered together.

The Office of the Public Advocate has an information kit which includes the Enduring Power of Guardianship form and explains the process of completing it in detail.

For further information on Enduring Power of Guardianship phone the Office of the Public Trustee on 1300 746 116.

3.   Advance Health Directive

An Advance Health Directive is a legally binding document that is used to explain your health care decisions, including your preferred treatments and procedures. It gives you the opportunity to document what you consent to, or don’t consent to, in specific circumstances.

This may include whether you receive palliative care, and life-sustaining measures such as assisted ventilation and cardiopulmonary resuscitation. An Advance Health Directive can also be used to refuse treatment for a current condition or terminal illness.

Treatment decisions outlined within an advance care directive come into effect only if you are unable to make or communicate your decisions.

The treatment decisions that you outline in your advance health directive can not be changed or refused by your enduring guardian.

An Advance Health Directive form can be downloaded, courtesy of the WA Department of Health.

To ensure your advance health directive can be accessed when it is needed, download an alert card which records key information in a wallet-sized card.

Want to learn more about advance care planning?

Come along to one of Palliative Care WA’s Advance Care Planning Community Workshops.

Health professionals and aged care workers can access information, guidance and resources to support advance care planning through ELDAC (End of Life Directions for Aged Care).

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