Advance care planning

Benefits of advance care planning

• Provides an opportunity for people to plan what is important for their future health and personal care, and to take comfort in sharing this with others.
• Enables decision-making to occur by the person without the pressure of acute clinical decline.
• Assists people to make decisions when they are able to communicate so they receive care that is consistent with their beliefs, values, needs and preferences if they become unable to communicate decisions.
• Reduces non-beneficial transfers to acute care and unwanted interventions.
• Improves patient and family satisfaction with care, with families experiencing less anxiety, depression and stress.

Obligations and legislative requirements

A range of legislative requirements also inform obligations for advance care planning:

• Guardianship and Administration Act 1990
• Criminal Code
• Common Law
• National Quality Standards for health services, general practice and aged care
• Codes of conduct and professional guidelines.

WA Health has developed a set of principles to promote a common understanding of advance care planning and consistency in how health professionals support the process in WA. Advance care planning:

1.  is voluntary, person-centred, and focused on empowering people to have choice and control over their future medical treatment decisions 
2.  is an ongoing process which the person can engage in at any point in time, and requires regular review allowing a person to make and change decisions as their circumstances and preferences change
3.  can be undertaken at any age and ideally commences before a person is unwell
   
   
4. is inclusive and can involve as many, or as few, people the person chooses to involve (e.g. family, carers, friends. health professionals, legal professionals)
5.  should be holistic and respect the whole person, with broad consideration of healthcare needs (i.e. not limited to medical treatments)
6.  should acknowledge and respect a person’s attitudes towards health and wellbeing, including cultural and spiritual considerations
7.  is focused on the person’s values, priorities and preferences and encompasses more than the completion of advance care planning documents
8.  may involve many, and sometimes challenging, reflections and discussions; these may need to be facilitated to ensure the person understands all their options when it comes to planning for their future care
9.  needs to follow an ethical process and support the person’s right to meaningfully participate in decision-making to the greatest extent possible.

There are 4 main elements to advance care planning: Think, Talk, Write, Share.

Health professionals can support people as they move between these elements and change their choices to suit changes in their personal situation, health or lifetyle.

Tip

• Use the Your Guide to Advance Care Planning in WA (PDF 1.6MB) to facilitate discussions. This consumer guide walks people through things to consider about their health, values, preferences and future care.

If you have concerns about the validity of an Advance Health Directive or Enduring Power of Guardianship, and the person has capacity, you should discuss your concerns with the person.

If the person does not have capacity, you should:

• follow your organisation’s internal processes for resolution of such concerns
• seek advice from your professional association
• consider making an application to the State Administrative Tribunal (SAT) (external site).