Advance care planning: Choice and control over health and wellbeing

Linda Nolte is an aged care professional who started her career as a personal care worker. She is now the Program Director at Advance Care Planning Australia and is passionate about enabling individuals to have choice and control over medical directives at the end of their life.

In her talk at Catalyst’s aged care industry roundtable, Linda discusses what advance care planning is, why it’s important and how it positively affects individuals and families.

What is advance care planning?

Advance Care Planning is a national organisation which promotes practical strategies to support an individual’s choice and control over future health care decisions. Their purpose is to provide national leadership, engagement, education and research to support increased advance care planning awareness and uptake.

Advance care planning enables individuals to have choice and control over their future medical treatment decisions which may include end-of-life care. Quality advance care planning allows individuals to legally appoint a substitute decision-maker, document their values and/or instructional preferences for future medical treatment.

Instructional advance care directives provide for consent to, refusal of and/or withdrawal of life sustaining interventions. It’s key that individuals have decision-making capacity to undertake advance care planning and document directives. Advance care directives will only come into effect when the person loses decision-making capacity and registered health professionals and ambulance service staff have obligations to access and enact these directives if required.

Watch Linda’s Industry Roundtable talk

Advance care planning prevalence study

Advance care planning ran a prevalence survey to understand how many Australians had engaged in advance care planning, particularly in the older population. The main findings were as follows.

The prevalence of advance care directive documentation in the adult Australian community is 14%.
The prevalence of advance care directive documentation in the older Australian (65+ years) community is 25%. 
The prevalence of advance care directive documentation in the older Australian (65+ years) residential aged care setting is 38%.
Only 17% of older Australians with dementia have any form of advance care directive.
30% of advance care directive documentation in aged care is not completed as per the legislation – by a competent individual but rather by someone less.

The Advance Care Planning prevalence research found that overall that there is a lack of awareness in the community around the legal implications of forms related to medical directives for those in aged care, despite a relatively high percentage of activity in this area.

What it needs is the framework and the guidance to ensure that it is done correctly and legally enabling people to have the proper choice and control over their medical treatments when they need it.