What is an Advance Care Directive, and why does the provider need it?
An Advance Care Directive records your future healthcare wishes for a time when you cannot make or communicate decisions. Your Support at Home provider needs to know it exists so relevant workers and clinicians can follow your wishes, contact the correct decision-maker and respond appropriately during a health crisis-but having one is your choice, not a condition of receiving care.
Key points
- Ask for details in writing and compare more than one option where possible.
- Individual eligibility, availability and outcomes can vary.
- Ask questions early and seek independent help if anything feels unclear or unsafe.
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01Guide sectionWhat is an Advance Care Directive, and why does my Support at Home provider need it?
An Advance Care Directive is a legal document that records your preferences and instructions for future healthcare in case you later become unable to make or communicate those decisions yourself.
It may describe:
your values and what quality of life means to you
treatments you would accept or refuse
preferences about hospital treatment or resuscitation
where you would prefer to receive end-of-life care
cultural, spiritual or religious wishes
the person authorised to make medical decisions for you, depending on the laws in your state or territory.
Advance Care Directive laws and terminology differ across Australia, so the document should meet the requirements of the state or territory in which it was made.
02Guide sectionWhen is the directive used?
The directive is generally used only when you no longer have decision-making capacity for the particular medical decision.
While you can understand, consider and communicate a decision, your current instructions take priority. A provider or family member should not use an old directive to override a decision you are currently able to make.
The directive may become relevant if, for example, you:
become unconscious
experience advanced dementia
develop delirium or severe illness
cannot communicate after a stroke
are approaching the end of life and cannot express your wishes.
03Guide sectionWhy does the Support at Home provider need a copy?
Your provider needs to know whether a directive exists so workers and clinicians can respond consistently with your wishes if your health deteriorates or an emergency occurs.
With your consent, the provider should record:
that an Advance Care Directive exists
where the current copy is kept
the date it was completed or most recently reviewed
who your medical decision-maker is
who should be contacted in an emergency
any instructions directly relevant to your home care.
This can help the provider:
brief nurses and other relevant workers
communicate accurately with ambulance, hospital and palliative care teams
avoid treatment that conflicts with your documented preferences
coordinate end-of-life care
involve the correct medical decision-maker
reduce uncertainty and conflict among family members.
Current aged care standards require providers to support people who choose to discuss, prepare or review advance care planning documents and to involve an appropriate substitute decision-maker when required.
04Guide sectionDoes every support worker need to see the whole document?
Not necessarily.
The provider should protect your privacy and give workers only the information they need for their role.
For example:
a nurse may need detailed clinical instructions
the care partner may need the full document and contact details
a general support worker may only need to know the emergency and escalation plan.
However, the document must be accessible to the appropriate person when an urgent medical decision is required. A directive that nobody can locate is of limited practical value.
05Guide sectionDoes it replace my care plan?
No.
An Advance Care Directive deals mainly with future healthcare and medical-treatment decisions.
Your Support at Home care plan covers your current day-to-day services, such as:
personal care
nursing
meals
mobility support
domestic assistance
medication assistance
worker routines
risks and emergency contacts.
The provider’s care plan should refer to the directive where relevant, but the two documents serve different purposes.
06Guide sectionIs it the same as a power of attorney?
No.
An enduring power of attorney usually relates to financial, property or personal matters, depending on the state or territory.
A medical treatment decision-maker-or the equivalent appointment in your jurisdiction-is authorised to make healthcare decisions if you cannot make them yourself.
A person who manages your banking or finances does not automatically have authority to make medical decisions.
In Victoria, an Advance Care Directive can contain legally binding instructions and values about future medical treatment. A separate form is used to appoint a medical treatment decision-maker.
07Guide sectionDo I have to create one?
No. You can receive Support at Home without an Advance Care Directive.
A provider should not pressure you into completing one or make it a condition of ordinary care.
However, advance care planning is particularly useful if you:
have dementia or another progressive condition
live alone
have significant clinical needs
have strong views about particular treatments
are receiving palliative care
have family members who may disagree about your care
want to remain at home near the end of life.
Only a person who has the relevant decision-making capacity can create their own valid Advance Care Directive. Family members cannot write one later on the person’s behalf after capacity has been lost.
08Guide sectionWhat should the provider do with it?
The provider should:
obtain your permission to retain a copy
store it securely
record it in the care and emergency plans
ensure relevant staff can access it
confirm which version is current
communicate it to external clinicians when necessary and authorised
review the arrangements with you when your circumstances change
return or update records if you revoke or replace the directive.
The provider does not interpret complex medical instructions independently. Doctors and other authorised health professionals determine how the directive applies to a particular treatment decision.
09Guide sectionWhat should I do after completing one?
Give copies to the people likely to need them, including:
your medical treatment decision-maker
your GP
relevant hospital or palliative care teams
your Support at Home care partner
a trusted family member or supporter.
Keep the original somewhere accessible and tell people where it is stored.
Review it when:
your health changes
you receive a new diagnosis
your preferences change
your appointed decision-maker is no longer suitable or available
you move interstate
you begin palliative or end-of-life care.
10Guide sectionWhat should I do next?
Confirm the details with My Aged Care or the relevant provider, write down your questions and ask for important information in writing before making a decision.
11Guide sectionHelpful Local Home Help resources
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