Advance Care Directive

If serious illness strikes you or your family, how do you talk about what happens next?

Perhaps it’s time to talk about completing an Advance Care Directive. It’s how you – or someone you love – can communicate to family and medical professionals what health care choices to have or not to have. It might not be the easiest conversation to start, but it will mean that your choices aren’t left to others to decide at a time when you might not be able to communicate them yourself.

Plan ahead

Why is planning ahead a good idea?

If you think or know you’ll become ill, you can tell people how to care for you in the future.

  • You still have a say in what will happen if you can no longer speak for yourself.
  • It helps people if they have to choose for you at some time in the future.
  • It can give you peace of mind because you’ll have told your wishes to the people that matter to you.

What happens if you don’t plan ahead?

The choices other people make for you will often be the same as those you would have chosen for yourself. But if they’re not, it could mean that:

  • You may get treatments and care that you don’t want, including being taken to hospital.
  • You may miss out on treatments and care that you do want.
  • You or the people that matter to you may have to deal with complex legal issues.
  • The people that matter to you may get confused and stressed making choices about your care without knowing what you would have chosen.
  • You may miss chances to talk about this while you’re still able to.

1Think and talk

What is Advance Care Planning?

Advance care planning is thinking and talking about your future healthcare and personal choices with the people who matter to you. This includes your healthcare team – your doctor or nurse. The more you talk about your healthcare choices, the better people will understand your wishes.

Advance care planning helps you to work out what you’d like to happen in the future if you become so ill that you can’t make choices for yourself, or you’re unable to express those choices to others if you have mental health issues, become very unwell, or are getting some types of medical care.

That means not being able to:

  • understand information
  • remember information
  • use information to make a decision
  • tell others about the decision

2Write

What is an Advance Care Directive?

An Advance Care Directive is a legal form that you fill in to tell others what you want to happen if you become so ill that you can’t decide or talk for yourself.

You can make an Advance Care Directive when you are able to:

  • make decisions now about your future health care and treatment
  • understand what an Advance Care Directive is and what it means to make one

Your Advance Care Directive can include any information about what’s important to you to help you to live and die well. This can mean:

  • your religious or cultural beliefs, practices or needs
  • where you would like to be cared for
  • where you would like to die
  • any other things that give your life meaning, such as music, food, clothing or pets

You can also use your Advance Care Directive to say what specific treatments you do not want, and when you would refuse them. You must state these clearly, so it’s a good idea for your doctor to help you write this section.

Remember, your Advance Care Directive will only be used if you’re unable to communicate or make decisions about your health. This could be for a short time, or until you die.

Even if you’re under 18 years old, you can make an Advance Care Directive, but there are specific laws about this – talk to your doctor to find out more.

3Choose

Who makes my healthcare decisions?

Being able to decide for yourself is called your ‘decision making ability’.
If you still have decision making ability, you can choose a person to make choices about your healthcare by using a special legal process to choose an Enduring Guardian”. Your Enduring Guardian cannot change the wishes you have in your Advanced Care Directive.

If you do not have decision making ability or an Enduring Guardian, your doctor will ask someone to be a ‘person responsible’. This could be your husband, wife or partner, an unpaid carer, a relative or a close friend. The law says that this person can then make choices about your health and lifestyle.

If none of these people are available or willing, the Tasmanian Civil and Administrative Tribunal (TASCAT) will make a decision, or appoint someone called a “guardian”.

4Share

What do I do when I’ve filled in my Advance Care Directive?

Keep your Advance Care Directive with you in your home, where people can find it quickly.

Also give a copy to people who matter, such as your family, doctor, and others involved in your care.

If you have an Enduring Guardian, give them a copy.

If you are sick, someone may call an ambulance for you. Tell the ambulance team you have an Advance Care Directive, and where it is.

You can register your Advance Care Directive with the Tasmanian Civil and Administrative Tribunal (TASCAT). You can also upload your Advance Care Directive on your “My Health Record”. Doing this means that healthcare workers can read your Advance Care Directive if you can’t give them a copy.

You can also make a list of people who matter to you and keep it with your Advance Care Directive. This will help people who support and care for you know who to call if you become sick.

And if you want, you can put an end date on your Advance Care Directive.

If you have any questions about this, just talk to your doctor.

5Review

Can I change or cancel my Advance Care Directive?

You should check your Advance Care Directive regularly – perhaps with your GP at your annual check-up. If your health is getting worse or your treatment changes, you should check it more often.

If you need to change what’s in your Advance Care Directive, you must:

  • have decision-making ability
  • cancel your current Advance Care Directive and write a new one

To cancel your current Advance Care Directive you must:

  • mark a tick in the box in the section in your Advance Care Directive called “Revoking your ACD”
  • draw a line through each page and write your initials on each page
  • tell the people and services who have a copy that it has been cancelled
  • inform the Tasmanian Civil and Administrative Tribunal, if it was registered with them

You can then make a new Advance Care Directive, if you want to.

Remember to:

  • register your new Advance Care Directive with the Tasmanian Civil and Administrative Tribunal
  • give a new copy to the people and services who matter to you

6Register

In Tasmania, you don’t have to register your Advance Care Directive for it to be legally valid, but it’s a good idea if you want doctors and other health professionals to quickly know your health preferences if you are unable to give them a copy.

You can register your Advance Care Directive with the Tasmanian Civil and Administrative Tribunal (TASCAT) to make sure your wishes are easily available in case of an emergency. It is free to register.

To register you must:

  1. Complete the Advance Care Directive document as per the legal requirements
  2. Complete the ACD Registration Application form – this must accompany your Advance Care Directive when registering it with the Tribunal
  3. Register your original Advance Care Directive with the Tribunal either in person or via post

The Tribunal may reject registration if the Advance Care Directive doesn’t meet the Tasmanian Guardianship and Administration Act’s formal requirements. You cannot register an Advance Care Directive that is not on the Department of Justice Advance Care Directive form under the legislation, however an Advance Care Directive in other written forms may still be covered under common law. You cannot register a non-written Advance Care Directive with the Tasmanian Civil and Administrative Tribunal (TASCAT).

For more information about advance care planning laws in Tasmania visit the Tasmania advance care planning laws | Advance Care Planning website .For in-depth legal information visit the Tasmanian Legal Aid Website for guidance and support on legal matters or consult your lawyer.

If you need an interpreter, please call 131450 (TIS) first, and state the language you speak.

Palliative Care Tasmania acknowledges the Traditional Owners and Custodians of lutruwita (Tasmania) Aboriginal land, sea and waterways.
We recognise, with deep respect, the traditional owners of this land, the palawa people and their Elders past, present and emerging.