The Advance Care Directive (ACD) is a a new document introduced in Victoria to assist in advance care management (see the videos below). The ACD empowers a person to make clear legal arrangements for their future health treatment, end of life care, preferred living arrangements and other personal matters. The ACD replaces the Enduring Power of Guardianship and Enduring Power of Attorney (Medical Treatment), and works in conjunction with the new Appointment of Medical Treatment Decision Maker.
What is an Advance Care Directive?
NOTE: For a quick overview of the ways an Advance Care Directive can assist you, see the set of short (90 seconds) videos at the bottom of this page.
In Victoria, an ACD is the only legally recognised document that a person can create in order to communicate and confirm their medical treatment preferences. It only comes into effect if you are unable to make your own decisions, and allows you to refuse or withdraw medical treatment and consent to the commencement of treatments. It also allows for instructional directives and values directives.
When making your ACD you can:
- write down your values and preferences for your future medical treatment as a way to guide your Medical Treatment Decision Maker (known as your “values directives“); and
- make statements that are legally binding on your health practitioners, in which you can consent to, or refuse specific kinds of future medical treatment, including mental health treatment (known as your “instructional directive“)
By making an ACD while you have the capacity to do so, you provide instructions and guidance to those who will become responsible for caring for you in the event that you can no longer make decisions for yourself, whether this is through temporary incapacity (accident or illness), age related loss of capacity, or end of life.
Who can make an Advance Care Directive?
Any person who is over the age of 18 years and has full capacity can make an Advance Care Directive.
When should I make my Advance Care Directive?
Now! You cannot make an ACD after you have lost capacity, and an ACD only comes into effect when the maker loses capacity, whether temporarily or permanently.
What should I consider when making my Advance Care Directive?
NOTE: For a quick overview of the ways an ACD can assist you, see the set of short (90 seconds) videos at the bottom of this page.
Some of the things you may wish to consider when making your ACD may include the following:
- What matters most in my life? What does “living well” mean to me?
- What worries me most about the future?
- For me, unacceptable outcomes of medical treatment after illness or injury are (e.g. loss of independence, high-level care, being unable to communicate or to recognise people).
- What religious or cultural matters have significance for me?
- Are there other people I would like involved in discussions about my care?
- If I am nearing death, what things would be important to me?
- Do I want to be considered for organ donation?
How much detail is required in my Advance Care Directive?
As much or as little as you want. It may be a simple statement about organ donation, or it may be a complex set of values directives, together with instructional directives about specific medical procedures.
Who should know about my Advance Care Directive?
It is important that your Medical Treatment Decision Maker should be aware that you have made an ACD. You should also ensure that a copy of your ACD is delivered to your medical practitioner before admission to hospital, or that it is readily accessible in the event that you are taken to hospital in an emergency.
We recommend that you keep the original signed copy of your ACD in a safe place. Alternatively, we can store your ACD indefinitely for you, and provide you with certified copies to give to those who may require them.
Other ways to make sure your ACD is readily available to those who might need to refer to it include:
- uploading a copy of your ACD to the online encrypted portal that we can create for you as our client (no additional cost)
- uploading a copy to My Health Record at www.myhealthrecord.gov.au
- giving a copy to your health practitioner and/or your hospital
- giving a copy to any other health practitioners who will need to access it.
How long does an Advance Care Directive Last?
You have the option of including an expiry date in your ACD, but it is not a requirement.
Like your Will, it is recommended that you review your ACD once every two years, or whenever your medical or personal situation changes. (Keeping your Advance Care Directive with your Will may be a helpful way to ensure that you remember to review it regularly.)
You may choose to include an expiry date as a safeguard in case you forget to review your ACD. However, do bear in mind that if you include an expiry date, your ACD could expire when you do not have decision-making capacity to complete a new one.
What are the formalities of making an Advance Care Directive?
We recommend that, when making your ACD you, should also formally appoint your Medical Treatment Decision Maker. To make a valid ACD you need to sign in front of two witnesses. One must be a registered medical practitioner (a medical doctor).
Neither witness can be someone you have appointed as your medical treatment decision maker.
Your ACD is valid as soon as it is signed and witnessed correctly, but it can only be used when you do not have decision-making capacity to make decisions for yourself.
Can I change my Advance Care Directive?
Yes, an Advance Care Directive made previously under the Medical Treatment Planning and Decisions Act 2016 (Vic) is automatically revoked when you make a new one.
Video examples of how an Advance Care Directive can assist
The following videos were created by SA Health, a department of the Government of South Australia. There are some minor differences in the way an ACD is prepared in South Australia, but the videos are helpful in explaining the concept of the ACD and how it helps people in different circumstances. We recommend that you watch each of these videos to gain a better understanding of the ways in which an ACD may assist you and those close to you.