An individual with decision-making capacity can document their preferences for care, values and/or appoint a substitute decision maker by completing the relevant jurisdictional Advance Care Directive (ACD) form(s). An ACD is completed and signed by a competent adult, but only comes into effect when the person loses capacity to make medical decisions. All health professionals have obligations to access and implement ACDs that comply with legislation, common law or policy, and support quality palliative and end-of-life care.
Despite comprehensive legislation, policy, forms, resources and guidelines, there is limited awareness and uptake of advance care planning across Australia, health sectors, the workforce and consumers. Nationally, the uptake of advance care planning remains low with 75% of Australians aged 65+ having not completed an ACD. In residential aged care facilities, 62% of residents aged 65+ do not have an ACD completed by them in their health record.
There are issues with the accuracy, currency and validity of advance care directives, particularly within aged care.