Why is advance care planning important for me?

Advance care planning is a way that a person can let their family, doctors, and others, know what health care is important to them. The information in an advance care plan can increase the likelihood a person will receive the medical treatment that fits the goals for their life and is in their best interest. This becomes even more important as a person nears the end of their life.

Each person is unique and each person’s choices for their health care will be just as unique. You may choose to participate in advance care planning because it can give you an opportunity to think and talk to your loved ones and doctors about your health care choices for the future. Importantly, it can give you the opportunity to write down your preferences. If a time comes when you cannot speak for yourself, your health carers will still know what you want and who you would like to make decisions on your behalf.

Any medical treatment plan needs to be acceptable to the person receiving that treatment. Some treatments may be absolutely desirable for some people, while the same treatments for others may be totally unacceptable. Often in a medical crisis, a person cannot make their own wishes known. This means that without a spokesperson, or a substitute decision maker, they may have medical treatments that they might not have chosen for themselves.

Who needs to do advance care planning?

Every adult should consider planning now for their future health care, regardless of their age or health. Making your decisions known ahead of time is especially important for people who have ongoing health problems or a life limiting illness or terminal condition. Most people feel better about their health care when they take part in making these decisions.

Anyone who has clear ideas about what health care they may or may not want from their doctors and health care providers when they are nearing the end of their lives should complete an advance care plan.

There may come a time when you can't speak for yourself. If that happens your doctor and your family will want to know what kind of care you want.

The advance care planning documents in Queensland are:

• Advance Health Directive (AHD)
• Enduring Power of Attorney (EPOA)
• Statement of Choices
• Revocation of an Enduring Power of Attorney (EPOA)

What if someone close to me can't make decisions for themselves?

When a person has not previously completed an advance care plan, and cannot make decisions or speak for themselves now, someone will be asked to make decisions and give consent for medical treatment on their behalf.

You may already be the carer, or appointed as a guardian or attorney for someone close to you who cannot make independent health care decisions.  You can write down what you believe the person would have chosen for themselves if they could do so. As their substitute decision maker you can write down these choices in a Statement of Choices Form B.   

What is an Advance Health Directive?

The Advance Health Directive is a legal advance care planning document stating a formal set of instructions for your future health care. It is used in certain circumstances, to inform your doctors of your choices when you become unable to make health care decisions for yourself.

This form allows you to record your wishes relating to certain specific medical circumstances. It can only be completed while you have decision-making capacity for your future care and, once completed, it is a legally binding document. It must be completed with your doctor and witnessed by a Justice of Peace (JP), Commissioner of Declarations (Cdec), a lawyer or notary public.

You can revoke your Advance Health Directive, in writing, while you are mentally capable of doing so and can complete a new form.

Read more about the Advance Health Directive.

What is the difference between an Advance Health Directive and a Statement of Choices?

Both the Advance Health Directive and Statement of Choices were developed for use in Queensland. These documents are only used for health care decisions when a person is unable to make decisions for themselves.

How do I contact the Statewide Office of Advance Care Planning?

Statewide Office of Advance Care Planning
PO Box 2274, Runcorn Qld 4113
Phone: 1300 007 227
Fax: 1300 008 227
Email: acp@health.qld.gov.au

What will happen if I do not complete an EPOA for health matters?

If you have not appointed someone to be your substitute decision maker for health matters under an EPOA or AHD, Queensland Law enables a Statutory Health Attorney to make health decisions for you. You don’t need to do anything to appoint a statutory health attorney.

Read more about decision makers.

Do I need to complete all three documents: Advance Health Directive (AHD), Enduring Power of Attorney (EPOA) and Statement of Choices?

Advance care planning is a voluntary process. You can complete whatever forms you consider meet your needs.

It is recommended that you complete an EPOA to legally appoint your substitute decision maker(s) and that you discuss your health care choices with them. Whoever you  appoint may ultimately be your substitute decision maker(s). They will need to know your preferences for health care treatments to be able to speak on your behalf.

Which of the three documents will be the best for me?

It depends on your individual preference and situation.

If you are unsure or you need further help, your doctor or another health care professional may be able to guide you. You may also like to talk to someone from the Statewide Office of Advance Care Planning on 1300 007 227 or email: acp@health.qld.gov.au

What happens if I don't have an advance care plan?

If you cannot make decisions or speak for yourself and you have not made a plan or appointed someone as your decision maker, your Statutory Health Attorney will be asked to make decisions and give consent for medical treatment on your behalf.

This could mean you are given medical treatments you may not have chosen for yourself, especially if your Statutory Health Attorney has not previously had an opportunity to discuss your beliefs, values and interests with you. Your Statutory Health Attorney may be faced with a lot of responsibility making decisions in a crisis, when emotions are high. Your quality of life may be affected as a result and the memories of this will stay with your loved ones.

Whether you have an advance care plan or not, you will still receive the best care possible. Your health conditions will be managed by health professionals according to good medical practice and you and your family will be well cared for.

Read more about end of life care and potential healthcare choices.

Who should I choose to be my substitute decision maker?

Your substitute decision maker is expected to act in your best interests and make decisions they believe you would have made for yourself.

The person you ask to be your decision maker for health matters should be someone you trust to listen carefully to your wishes for future medical treatment and to then faithfully represent you when you can no longer speak for yourself.

He or she may be required to make complex health decisions in difficult, sometimes emotional, situations so you need to be reassured that they can do this.

Your decision maker may be a family member or  can be any adult who you believe will best fill this role.

Read more about substitute decision makers.

Where can I find more information about advance care planning and voluntary assisted dying?

This factsheet provides consumers with more information about advance care planning and voluntary assisted dying in Queensland.

Health care workers can access more information and clinical practice guidelines about advance care planning and voluntary assisted dying here.

Statement of Choices

What is the Statement of Choices?

The Statement of Choices is a Queensland advance care planning document and comprises two forms:

Statement of Choices Form A: is designed for you to write down your health care values and preferences. It provides a way for you to inform your family and your doctors of your health care wishes so that in the future, if you are unable to speak for yourself, this document will help guide them.

You can change your Statement of Choices document whenever you choose to review your plan. If you decide to make changes, it is wise to make this clear on a new form. Your family, substitute decision maker and your doctor should be told about any changes you wish to make.

When you revise or change your Statement of Choices document you are encouraged to send a copy of your completed Statement of Choices document to the address details on the form (bottom of page 4). This ensures your most recent Statement of Choices document is available and kept on your Queensland Health electronic hospital record. (See “What do I do with my completed Statement of Choices?” below)

Statement of Choices Form B: can be used by the substitute decision maker for someone who cannot make decisions for themselves. Complete Form B on behalf of the person and state what you believe is in their best interests, taking into account their expressed wishes and the views of their significant others. 

How can I get a Statement of Choices document?

You can download the Statement of Choices form on this website or you can contact the Statewide Office of Advance Care Planning for a paper copy:

Statewide Office of Advance Care Planning
PO Box 2274, Runcorn Qld 4113
Phone: 1300 007 227
Fax: 1300 008 227
Email: acp@health.qld.gov.au

Do I need a doctor to complete a Statement of Choices?

It is wise to include your doctor as well as your loved ones and your substitute decision maker(s) in your discussions about your health choices.

Your doctor should review and sign your completed form. This will give other doctors, who may need to treat you in an emergency, confidence that you were well informed medically when you made your decisions.

Do I need someone to witness my Statement of Choices?

No, an eligible witness such as a Justice of the Peace, Commissioner of Declarations, Notary Public or lawyer, is not required to witness a Statement of Choices.

Can my Statement of Choices be changed?

Yes, you can change your Statement of Choices while you are still able to make medical decisions for yourself.

If you wish to make changes it is best to complete a new Statement of Choices form and destroy the old document.

It is important that you tell everyone who had a copy of your previous Statement of Choices that you have completed a new document. Make sure your substitute decision maker or spokesperson understands your new choices, and give them a copy of your new plan. Remember also to send a copy of your new document to the address details on the form (bottom of page 4) so it can be added into your secure Queensland Health electronic hospital record.

What do I do with my completed Statement of Choices?

Keep the original document yourself in an easily accessible place. Some people choose to keep the document in a protective cover on, or even in, the fridge.

Give a copy of your document to your substitute decision maker(s) and family members. Include friends in your support network, if you wish. Take a copy to a private hospital if you are to be treated there.

Please send a copy of your completed Statement of Choices document to the address details on the form (bottom of page 4). Your Statement of Choices will be added to your secure Queensland Health electronic hospital record so that it is available if required.

Terminology

What does advance care planning mean?

Advance care planning means thinking about your future health care choices and sharing your values, beliefs and treatment preferences with your family, friends and health care providers.

Planning in advance helps those close to you make health care decisions on your behalf if you are unable to make those decisions for yourself. It provides comfort for you and your loved ones knowing you have done your best to ensure your wishes can be respected. Advance care planning is a completely voluntary process.

What is a 'life-limiting illness' or a 'terminal condition'?

A life-limiting illness is the term given to an illness that is incurable or not reversible. It is expected that a person with a life-limiting illness will live a shortened life as a result of the illness. The length of life will vary depending on the person and the type of illness.

A terminal condition is an illness or disease that cannot be cured or adequately treated and is reasonably expected to result in the person’s death in a short period of time.

What is an Enduring Power of Attorney (EPOA)?

An Enduring Power of Attorney (EPOA) is a legal form that enables you to appoint one or more individuals to make personal, health and/or financial decisions on your behalf.

You can appoint more than one individual. Consider whether it may cause practical difficulties if too many people are expected to be involved in making decisions on your behalf. You can nominate whether each person can make decisions independently or whether you want them to make decisions jointly.

The individual(s) you select and appoint with your EPOA is called your attorney. Choose your attorney(s) carefully, especially if there is likely to be family conflict. Your attorney(s) should be trustworthy, available to speak to doctors and family members, and able to make decisions in your best interests.

Health decisions can only be made on your behalf if you no longer have the ability to make those decisions yourself.

Read more about the Enduring Power of Attorney.

What is a substitute decision maker?

A substitute decision maker is a general term used to describe a person who has legal power to make decisions on behalf of an adult when that adult is no longer able to make their own decisions.

You can appoint an individual or several people, while you have legal decision-making capacity, using the Enduring Power of Attorney form.

If you have not previously appointed anyone and if you are no longer able to make decisions or complete legal documents for yourself then the law provides for a Statutory Health Attorney to make health care decisions on your behalf.

What is a Statutory Health Attorney?

A Statutory Health Attorney is a person who is most readily available and appropriate to make health care decisions for you if you become unable to make them because of illness or incapacity.

A Statutory Health Attorney cannot be appointed ahead of time; the person acts in this role only when the need arises. The first available individual who has a relationship with you and is culturally appropriate becomes your Statutory Health Attorney. Usually this would be your spouse or de facto partner; a person who is responsible for your primary care but not paid to be your carer or a close friend or relative over the age of 18 years.

The Public Guardian may, under certain circumstances, become your Statutory Health Attorney. For further information please visit the Public Guardian website. 

Who is the Public Guardian and what is its role?

The Office of the Public Guardian is an independent body, working to protect the rights and interests of adults who have impaired capacity to make their own decisions.

The Public Guardian may be called upon to make health care decisions directly on behalf of an individual or may provide assistance to their substitute decision maker.

For more information, visit the Public Guardian website, or phone 1300 653 187 or 07 3234 0870.