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Advance Care Planning Australia LearningTM supports health practitioners, care workers, students, individuals and substitute decision-makers to learn about advance care planning. Our program is funded by the Australian Government.

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Advance Care Planning Australia Learning TM supports health practitioners, care workers, students, individuals and substitute decision-makers to learn about advance care planning. Our program is funded by the Australian Government.

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Local prompts for Home Based Palliative care patients- patient may have an Emergency Medication Kit:

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Local prompts for Home Based Palliative care patients- patient may have an Emergency Medication Kit:

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Many of our patients will have these medications in their homes.
We will ring the Specialist on call via Calvary Switch to attain an order for a first dose of any of these medications.

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This is signed by a palliative care MO or GP

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Supportive & Palliative Care Indicators Tool (SPICT)

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Supportive & Palliative Care Indicators Tool (SPICT)

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GETTING IN FRONT OF THE PALLIATIVE CARE NEEDS OF ALL PEOPLE WITH A LIFE LIMITING ILLNESS!

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Welcome to the SPICT CommunitySPICT™ is used to help identify people with deteriorating health due to a new serious illness, and those with one or multiple advanced conditions so they benefit from …

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24 hr number for those receiving specialist palliative care

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24 hr number for those receiving specialist palliative care

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Everyone should have one!

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Information for families and carers caring for a person with a life limiting illness

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Information for families and carers caring for a person with a life limiting illness

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https://www.pallcareact.org.au/wp-content/uploads/2020/08/PalliativeCare_Booklet_2020_ACT_Digital2.pdf

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Try the QR code below to upload

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https://www.health.act.gov.au/services-and-programs/end-life-and-palliative-care/when-someone-dying

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Families and Patients can book themselves in

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Leo’s Place is a beautiful, comfortable residential home open to clients aged over 18 years who have been medically diagnosed with a life-limiting illness.

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https://www.endoflifeessentials.com.au/tabid/5195/Default.aspx

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https://www.advancecareplanning.org.au/law-and-ethics/state-and-territory-laws/advance-care-planning-laws-in-act

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The information on this page relates specifically to advance care planning laws in the Australian Capital Territory (ACT). Find out how to create your plan in the ACT.

Law and policy in Australia and the ACT

All states and territories have law and/or policy related to advance care planning to support person-centred medical treatment decision-making and advance care directives.

In the ACT, both statutory and common law advance care directives exist and are legally binding. These can include a person's values, preferences for future treatment (consent to, refusal of and/or withdrawal of treatment) and appointment of a substitute decision-maker. They should be completed and signed by a competent adult. Preferably, they should be stored and accessed via My Health Record.

In the ACT, a person with decision-making capacity can:

A Health Direction and the role of the substitute decision-maker comes into effect when the person loses decision-making capacity.

Substitute decision-makers

A substitute decision-maker can make medical treatment decisions on behalf of a non-competent person.

In ACT, the substitute decision-maker can be:

chosen and appointed by the individual as an attorney (one or more attorneys can be appointed)

a guardian appointed by the Australian Capital Territory Civil and Administrative Tribunal Board (ACAT)

a default decision maker (health attorney). This will be someone who is 18 years or older and has a close and continuing relationship with the person, chosen in the following order:

1. The person's spouse or domestic partner

2. An unpaid carer of the person

3. A close relative or close friend of the person

An appointment by ACAT overrides all other appointments.

Appointing an attorney

An attorney appointment should be on the recommended Enduring Power of Attorney form. It must be written in English, contain details of the appointer and person(s) being appointed. The person(s) being appointed must sign that they accept the appointment.

Document signing must be witnessed by two adults - one of whom is a person authorised to witness the signing of a statutory declaration. Neither witness can be a person who is being appointed. More than one person can be appointed and they can be appointed to act jointly or severally. The person(s) being appointed must be at least 18 years old.

The attorney(s) can refuse or withdraw treatment on behalf of the person if expressly authorised to do so and they have consulted with the treating team. They must make the decision they believe the person would make (i.e. substituted judgement).

Advance care directives

Only people with decision-making capacity can complete an advance care directive - Health Direction or Advance Care Plan Statement of Choices (competent person). It should be on the recommended Health Directionform or Advance Care Plan Statement of Choices (competent person) and can provide specific directions about treatment that they would consent to, refuse and/or withdraw.

An advance care directive must be written in English, include the person's full name and address. It must be signed by the person and witnessed by two adults. Neither witness can be a person appointed as an attorney.

The role of advance care directives when making medical treatment decisions

Advance care directives in the ACT include Health Directions, Advance Care Plan Statement of Choices (competent person) and Enduring Power of Attorney documents.

Any person with decision-making capacity is able to make their own decisions, including decisions related to life-saving treatment. All adults are presumed to have capacity unless there is evidence to suggest otherwise.

Consent must be obtained before any treatment is provided, withheld or withdrawn. If a person does not have decision-making capacity, all reasonable efforts must be made to locate a Health Direction or Advance Care Plan Statement of Choices (competent person) form and identify an attorney. The only exception to this is when emergency treatment is required and an advance care directive or attorney is not available.

If there is an instructional directive refusing medical treatment, a health practitioner cannot provide treatment. An attorney cannot override a valid advance care directive.

If there is a values directive / Statement of Choices (no legal capacity) and the person has not completed an advance care directive, the attorney is required to provide informed consent before treatment is provided. The attorney and the health practitioner must consider information in the values directive or advance care plan, but it is the attorney who is required to make the decision.

If an advance care directive or attorney cannot be located, the ACT Civil and Administrative Tribunal (ACAT) can provide guidance on the process for proceeding.

Changes and revocation

A Health Direction ends when a new Health Direction is completed, a person with capacity revokes their Health Direction, or it expires (if an expiry date is included), or the person who made the Health Direction dies.

An attorney appointment ends if a person with capacity revokes the appointment of attorney, if all people appointed are unable to act, or if the person who made the appointment dies. If the person making the appointment marries someone who is not their attorney, the attorney's appointment is revoked, unless the 'marriage, civil union or civil partnership'section of the appointment form is completed indicating otherwise. The person appointed as attorney can also resign from their appointment.

Under certain circumstances the ACT Civil and Administrative Tribunal (ACAT) can cancel a Health Direction or attorney appointment.

Advance care planning in the context of mental health

For people with mental illness who maintain decision-making capacity, advance care planning occurs in the same way as for everyone else. An advance care directive can include preferences relating to mental health treatment. They receive treatments under the same laws unless treated under the Mental Health Act 2015when an Advance Agreement, an Advance Consent Directionand appointment of a Nominated Person may be relevant.

Advance care planning for people less than 18 years old

Children can do advance care planning and document their preferences, however, there is no advance care directive legislation pertaining to a person less than 18 years of age and they are not legally binding. A person less than 18 years old cannot appoint an attorney.

Applicability in other states and territories

In general, a valid ACT Health Direction will apply in other states and territories in Australia, although there may be some limitations and additional requirements. It may be recognised under common law.

Similarly, an appointment of an attorney will usually apply, but there is variation in the laws within Australia. It is recommended that a person obtain specific advice from the Office of the Public Advocate or equivalent in the relevant state or territory.

If a person is permanently moving state or territory, it is recommended that they update their documentation using the recommended form(s).

Advance care directives from other states and territories

There are currently no provisions in the ACT for the recognition of advance care directives made in other Australian jurisdictions. However, these documents may be valid under common law.

A valid interstate appointment of a substitute decision-maker(s), is recognised in the ACT as an attorney.

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The information on this page relates specifically to advance care planning laws in the Australian Capital Territory (ACT). Find out how to create your plan in the ACT. All states and territories have law and/or policy related to advance care planning to support person-centred medical treatment decision-making and advance care directives.

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Planning for another PEPA workshop February 2023
Biennial to be the aim for future PEPA planning

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Victoria Ambulance mental health strategy

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Victoria Ambulance mental health strategy

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Hand Held fans; Make Breathlessness a Breeze!

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Hand Held fans; Make Breathlessness a Breeze!

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Helps understand medication use in palliative care setting; and the role of the caring@home package

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Before documenting your plan in the Australian Capital Territory (ACT), it's important to have a good understanding of what advance care planning is and what's involved in the advance care planning process.

On this page you can find advance care directives and other documents relevant to the ACT.

Recording your choices

In the ACT, there are three ways you can record your choices for future health care:

1. Complete an Enduring Power of Attorney

2. Complete an Advance Care Plan Statement of Choices (Competent Person)

3. Complete a Health Direction

Completing these documents is the best way to make your preferences known about the type of treatment you would want if you are unable to participate in decisions, and to ensure that family and health professionals respect these preferences.

Enduring Power of Attorney

An Enduring Power of Attorney (EPA) allows you to choose a trusted relative or friend to manage your health care, personal care and financial affairs. The person you appoint becomes your substitute decision-maker if you are no longer able to make decisions. An EPA is a legal document that gives your chosen attorney, the legal authority to act for you, and to make decisions on your behalf.

You can appoint one or more adults to this role. To do this you need to complete the Enduring Power of Attorney form.

The form has specific requirements for completing and witnessing. Your chosen attorney must accept this role by signing the form.

Your attorney can consent to or refuse treatment on your behalf. They must act in accordance with any lawful directions contained in the form. They must make the decision they believe you would make if you could make your own decision. For this reason, it is helpful to talk to them about what is important to you and any preferences you have.
Download an Enduring Power of Attorney form
Advance Care Plan Statement of Choices

An Advance Care Plan Statement of Choices (Competent Person) is an advance care directive and includes future medical decisions if you lose the ability to make or communicate these decisions yourself. It allows you to provide specific information relating to your preferences and values, and must be taken into account.

You can provide information about your choices for life-prolonging treatments and make requests for other treatments relating to specific conditions. You can also record things such as religious or spiritual wishes and personal matters you would like taken care of if you are nearing death.
Download an Advance Care Plan Statement of Choices (Competent Person) form
Completing an Advance Care Plan Statement of Choices for someone else

If a person is no longer able to make or communicate their decisions, an attorney can record choices regarding medical treatments and procedures on a person's behalf using the Advance Care Plan Statement of Choices (No Legal Capacity form).

This advance care plan isn't legally binding but can be useful to inform care decisions, and should be taken into account.

For an advance care plan form that can be used in all states and territories, use Advance care plan for a person with insufficient decision-making capacity.

Health Direction

A Health Direction is a legal document that enables you to make a direction to refuse, or require the withdrawal of, medical treatment generally or a particular kind of medical treatment.

Specific instructions

In your Health Direction, you can give specific instructions about certain medical treatments. For example, you might ask that life-prolonging treatment - such as tube feeding or resuscitation - be withheld or withdrawn if you have:

a terminal illness with no known cure or chance of recovery

severe and irreversible brain damage, and you can't communicate

a severe illness or injury that you'll probably never recover from

The Health Direction form must be completed and signed by two adult witnesses.
Download a Health Direction form
Storing your documents

Send copies of your documents to the ACT Advance Care Planning Program.

Documents can be scanned and emailed to acp@act.gov.au or posted to:

Advance Care Planning
GPO Box 825
Canberra City
ACT 2601

We also recommend uploading your documents to My Health Record.

It's important that you share copies of your documents with your attorney, family, friends, carers and your doctors. This will ensure everyone knows what you want.

You can also download and print a wallet card to let others know that you have an advance care directive.

Making changes and revoking documents

We recommend that you review your decisions and documents regularly. This is particularly important if there is a change in your health, personal or living situation.

You can change or revoke these documents at any time by completing a new document. The most recent dated document overrides the older document. It is important to inform your attorney/sand the ACT Health Advance Care Planning Program of the changes and provide them with copies of the new documents.

Your Health Direction ends when you complete a new Health Direction, you revoke it, it expires (if an expiry date is included) or you die.

Your Enduring Power of Attorney ends if you revoke it, if the people appointed are unable to act, if they resign their appointment or if you die.

Getting help

Contact our National Advance Care Planning Support Service TM on 1300 208 582 for more information and advice. We're available 9am - 5pm, Monday - Friday (AEST/AEDT).

for more information about COVID-19 and advance care planning

Applicability in other states and territories

In general, valid advance care planning documents will apply in other places in Australia, although there may be some limitations and additional requirements. Learn more about applicability in specific states and territories.

Legal information

For more in-depth legal information, read about advance care planning laws in the ACT.

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Australian Capital Territory: create your plan

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Before documenting your plan in the Australian Capital Territory (ACT), it's important to have a good understanding of what advance care planning is and what's involved in the advance care planning process. On this page you can find advance care directives and other documents relevant to the ACT.