Advance Care Directives

Life is like a jigsaw.  As we get older there are more pieces to consider and put into place.  Health tends to deteriorate with age and certain medical problems can arise at any age. Anyone of any age can be in an accident.  Preparing an Advance Care Directive is a way in which you can pass to others the authority to make health, care and medical related decisions for you if you cannot make those decisions for yourself.  For financial decisions see Enduring Power of Attorney.  It can also give you peace of mind knowing that medical matters and lifestyle decisions will be carried out in accordance with your wishes.  Without an Advance Care Directive your family may experience difficulties in arranging your medical care that they consider necessary or in accordance with your known wishes.

An Advance Care Directive allows you to appoint one or more “substitute decision-makers” who will have the power to make health and lifestyle decisions on your behalf should you lose your mental capacity (as determined by a health professional). A substitute decision-maker can only act on your behalf if you are unable to make your own decisions, whether that inability be temporary or permanent.

How many substitute decision-makers can I appoint?

The prescribed document allows for three names to be listed.  You can then indicate whether it is any one or all of the people named who can make decisions.  If your first choice of person dies or cannot act through their own incapacity, you can arrange an alternate substitute decision-maker to take their place.

You must have utmost faith and trust in the person you appoint and that they will act in your best interests and make the best possible decisions on your behalf in accordance with your wishes.  Often you would appoint a spouse and/or family members to have the responsibility for making health and medical decisions.

What can a Substitute Decision-Maker do?

Your substitute decision maker must give paramount consideration to the wishes and directions outlined in your Advance Care Directive.

Your substitute decision-maker may need to make decisions relating to some of the following:

• approving care and management plans
• choosing a healthcare professional (i.e. a doctor or dentist) and what treatments should be carried out
• consent to enter into a group home, hostel or nursing home
• authorise leisure activities, holidays, day programs and visitors
• accept or refuse treatments or medical procedures for you or life support if they believe that would be your wish (or it is stated in the document what your wishes are).

What if I do not have anyone to nominate to make decisions?

You can still prepare an Advance Care Directive if you do not have anyone who you wish to appoint to make medical or lifestyle decisions on your behalf.  The Advance Care Directive allows you to put in writing your medical and lifestyle choices, without the need to specifically appoint someone to make decisions.

What kind of wishes can I include?

You can nominate both binding and non-binding wishes if you have any preference of care or treatments that you would or would not want to have and matters for your substitute decision-maker to take into account when making a decision on your behalf. The type of wishes and preferences that you can include in your Advance Care Directive include (but are not limited to):

• what is important to you (physical and emotional)
• where you wish to live;
• binding refusal of care (life support or resuscitation)
• your dying wishes.

What if I do not have an Advance Care Directive and I become incapacitated?

You cannot sign any legal document after you have become legally incapacitated.  For a person to act on your behalf, a family member will need to apply to the South Australian Civil and Administrative Tribunal (SACAT).  In some instances, SACAT may appoint a family member as a substitute decision maker however they may appoint the Public Advocate especially if there is family conflict.  This bureaucratic process during a difficult time may cause delays and put your loved ones through unnecessary stress.

To download information on Advance Care Directives click here.

What about Enduring Powers of Guardianship?

The Advance Care Directive Form has replaced:

• Enduring Powers of Guardianship
• Anticipatory Directions
• Medical Powers of Attorney.

However, if you already have these previous documents in place, and they are:

• signed by you prior to 1st July 2014
• are fully and correctly signed by all other parties by 31st December 2015

Then the previous documents are still valid and effective and you do not have to replace them.  If you wish to make a change to the previous documents, then the new Advance Care Directive Form will need to be completed.

Whilst these Advance Care Directives are not intended to be documents that can only be prepared by your lawyer, many clients seek advice or assistance in their preparation.

You can complete them yourself by downloading them from the Advance Care Directives site online or by purchasing kits from Service SA centres.

We have offices in the city and at Tea Tree Gully for the convenience of clients.   In addition, for the elderly or infirm, visits can be made to clients at home or in hospital.

Call us on 08 8415 5000 or send an email to make an appointment.