Advance Care Planning
What is Advance Care Planning?
Advance Care Planning involves making your decisions about your end-of-life treatment explicit, so that your family and friends, and the medical team that cares for you, will know what you require and respect your wishes. The law in Victoria supports you in this process. In this section, we explore two aspects of Advance Care Planning:
- appointing one or more Medical Treatment Decision Makers (MTDMs); and
- completing an Advance Care Directive (ACD).
Medical Treatment Decision Makers
You should appoint one or more MTDMs. These would usually be family members, such as your children, or a close friend. If you lose decision-making capacity (through illness, dementia, or sudden accident), your MTDM can make known what treatments you would or would not want.
DWDV has two forms for you to use:
- 2a Appointment of a Medical Treatment Decision Maker. This form can be completed online and then printed.
- 2b Information for completing an Appointment of a Medical Treatment Decision Maker
Advance Care Directives
You should also fill out an ACD. Properly completed, this document has legal force to support your MTDM and to direct medical staff about the treatments you do not want in case you lose the ability to communicate those instructions.
DWDV has two forms for you to use:
Your Questions Answered
The Advance Care Planning process of appointing a MTDM and completing an ACD allows you to reflect on what is important to you about life. Reflecting on your values about life is a positive and reassuring process. Advance Care Planning also provides you with the tools to retain personal autonomy and dignity as you near life’s end. Conversations about your end-of-life wishes with those you love is an essential aspect of Advance Care Planning; the process provides a framework to discuss death and options about the end-of-life in a caring and pragmatic fashion.
One key benefit to you is peace of mind – that your wishes will be respected once you no longer have decision-making capacity.
The main benefit to loved ones is that they have guidance in making crucial decisions about your treatment. Your end-of-life is an emotional time for loved ones; it is a gift from you to alleviate their stress at this time.
Under law in Victoria (Medical Treatment Planning and Decisions Act 2016), you have the right to:
- appoint someone to act for you for when you no longer have decision-making capacity
- document your future medical-treatment wishes
- refuse/consent to medical treatment; and
- demand maximum relief of pain.
You can still complete an ACD if you have the early stages of dementia. However, you must be able to demonstrate to a medical doctor that you still retain consistent, fully informed decision-making capacity. It is in your interests to begin the Advance Care Planning process while your mental health is sound.
Have conversations with your loved ones about how you see the options for your end of life. These conversations might take time but are essential.
Appointing a Medical Treatment Decision Maker requires careful thought. It needs to be someone you trust, someone with the capacity and availability to carry out your wishes.
As for the legal forms, DWDV offers very clear online forms that can be used, as do other agencies. Note carefully the requirements for who should witness these documents. Once completed, your MTDM and ACD documents should be made widely accessible; uploading to My Health Record is useful.
Advance Care Directives and any other kind of medical treatment forms you have written, such as Enduring Power of Attorney (Medical Treatment) or a Refusal of Treatment Certificate, all remain valid legal documents. All of the information provided on this website is in accordance with the Medical Treatment Planning and Decisions Act 2016, which came into full effect on 12 March 2018. In Victoria, medical treatment decision-making sits under this Act, which was made with a view to simplify some laws and practices.
It is worthwhile consulting several other resources when making your Advance Care Plan. Here are five useful websites:
- Advance Care Planning Australia is an organization dedicated to assisting Australians with devising an Advance Care Plan. The section under ‘News, case studies and blog’ is an exceptionally rich resource with many personal stories on which to reflect.
- Health.Vic (Victorian Health Department) is another valuable resource.
- The Australian Government Department of Health has a clear and concise section on Advance Care Planning
- The Office of the Public Advocate has a comprehensive section on ‘Plan for the future’. This is a useful website for those that want a complete overview of end-of-life planning.
- Aged Care Guide, endorsed by the Council for Older Australians, the Aged Care Industry Association, the Aged & Community Services Association, and Leading Age Services Australia, has a section on ACDs.