We all have questions about the end of life, even though we usually don’t want to know the answers. It’s a tough subject to raise and discuss.

But there’s one thing that you do need to talk about with your family, as early as possible – and that’s planning in advance – so that your wishes are known and recorded for when the time comes.

Advance Care Planning is just like making a Will – it’s all part of planning for the future. It’s best to do it when you’re healthy and well. There’s no harm in deciding now – what sort of medical treatment do you want? Or not want? What medications would you like to be treated with, or not treated with? Remember, the end of life is different for different people, and you may or may not be able to communicate your wishes.

That’s why every state and territory in Australia has laws and procedures relating to Advance Health Directives. An Advance Health Directive is a legal document that you make, informing your doctors and medical staff of your wishes regarding your own care if you lose the ability to communicate. You would normally make an Advance Health Directive by filling out the forms relating to your state or territory, after looking at all your options and making your decisions.

Getting Started
The first step is to do your own research, to help you decide exactly what’s best for you. A great place to start is the Federal Government’s website about Advance Care Planning. It reads:
“Advance care planning is the process of planning for your current and future health care. It involves talking about your values, beliefs and preferences with your loved ones and doctors. This helps them make decisions about your care when you can’t. Ideally these conversations start when you are well and then continue throughout your life.”

It also has helpful information about making your own decisions:
“Start your advance care plan by thinking about what you want. You don’t need to make it complicated but it’s important to be open about what you would like. The next step is to talk to your loved ones. These conversations can sometimes be difficult. Having these conversations is important because this will let them know what your wishes are. If you want to, you can then formalise your advance care plan through an advance care directive. An advance care directive is a type of written advance care plan. It’s sometimes called a living will.”
(Source: https://www.health.gov.au/health-topics/palliative-care/planning-your-palliative-care/advance-care-planning )

Deciding Your Future
If you’re unsure what to take into account when making your decisions about future care, have a look at the Advance Care Planning website . It offers helpful advice about considering your current state of health, your future state of health and the impact of any past experiences of healthcare.

It also encourages you to discuss all your decisions with everyone around you:
“Speak to your family and others close to you about your views and preference for your medical care. A close or loving relationship does not always mean someone knows or understands your preferences. The more your loved ones understand your preferences, the easier it will be for them to help guide your medical treatment. You should also speak to your doctor. They can provide you with information and advice regarding your current health situation and what may happen in the future.”
(Source: https://www.advancecareplanning.org.au/understand-advance-care-planning/the-advance-care-planning-process)

Advance Health Directives
Once you’ve decided on your preferred care plan, it’s best to put your wishes in writing by making an Advance Health Directive. Remember, it comes into effect only if your cognitive
health deteriorates and you become unable to make your own decisions. Each state and territory has different forms and processes, and you can access all of them on the same Advance Care Planning website here.

When you’ve written your Advance Health Directive, you or your doctor can add it to your health records online (‘My Health Record’) for any future medical staff to see.

Substitute Decision-Makers
It’s important to note that you can also appoint a Substitute Decision-Maker as part of your Advance Health Directive. A Substitute Decision-Maker is someone who can make decisions on your behalf if required to.

The Advance Care Planning website recommends you choose somebody:
“…you trust, who is over 18 years, who will listen carefully to your values and preferences for future care, (and) who will be comfortable making decisions in difficult situations. When choosing your substitute decision-maker, you should ask yourself the question: ‘Am I confident this person will make decisions based on what I would want?’ You may also choose a second person (an alternate substitute decision-maker). They will be called on if your substitute decision-maker is unable to make decisions on your behalf.

Substitute decision-makers may have different titles depending on the Australian state or territory you are in. Some of the titles used are:
• Medical Treatment Decision-Maker or Medical Enduring Power of Attorney (Victoria)
• Enduring Guardian or person responsible (New South Wales, Tasmania, Western Australia)
• Enduring Power of Attorney (Queensland, ACT)
• Substitute Decision-Maker (South Australia)
• Decision-Maker (Northern Territory).”
(Source: https://www.advancecareplanning.org.au/understand-advance-care-planning/the-advance-care-planning-process )

Just Do It
Don’t put off making an Advance Health Directive. The best time to do it is now, before any urgent health condition arises. It’s particularly important to make one if:
• You’re about to be admitted to hospital,
• Your medical condition is likely to affect your ability to make decisions in the future,
• You have a chronic medical condition that could cause serious complications, such
as diabetes, asthma and heart or kidney disease.

If you need any more convincing to make your Advance Health Directive a priority, remember that it benefits everyone: you, your family, your carers and your health professionals. It helps you to ensure you receive the care you want, in the specific location that you want to be receiving care (such as your own home, or a hospital if you prefer). It can also improve ongoing and end-of-life care by properly informing your current and future healthcare workers of your wishes, which may reduce unnecessary transfers to hospitals or unwanted treatments and medications.

Certainty Offers Comfort
Advance Health Directives allow everyone in your family the comfort of knowing you are receiving the care you wanted, in the way you wanted, at the time you need it. They may help you and your family members be more certain, satisfied and assured during what will undoubtedly be a challenging time.

Planning head is always easier to do when you are fit and healthy. So, start the conversation with your loved ones now, and talk about the type of health care you would prefer. Make others aware of your wishes by putting it all in writing. Help them make the right decisions at the right time for you. It will make a very difficult time a lot easier, and put your mind at ease that your wishes will be carried out.

We owe it to our loved ones to be prepared. The last thing you want is to leave your family worrying about what decisions you might have made differently. Take charge now and get your wishes and affairs in order.