Advance Care Planning (ACP)

Advance Care Planning is about planning ahead for your future healthcare, in case you are ever too unwell to speak for yourself.

Advance Care Planning (ACP) is about you

It’s about planning ahead for your future healthcare

ACP gives you a voice when you are too unwell to speak for yourself

Who can make an Advance Care Plan?

It is important we all consider Advance Care Planning, however, it is particularly important if:

  • You have chronic health concerns
  • You have health conditions that may affect your ability to make decisions in the future
  • You have firm preferences about future medical treatment
  • You have preferences for your health care that are different from what you think your family would want for you
  • You have no-one, or no-one suitable, that you could appoint as a Medical Treatment Decision Maker

Where to start?

1. Be Informed

Start by talking to your family, friends and doctors about your values, beliefs and health care preferences. Be fully informed of health issues you have or are likely to have in the future by talking to your doctors or other health professionals.

You might find these videos and written information helpful to understand the importance of talking about your future healthcare preferences.

Video: Love is not enough

A video from Advance Care Planning Australia. How well do you know your partner? Are you prepared for life’s toughest decisions?

Video: Taking Care of Dying Time

A video from Central Hume Primary Care Partnership. Chris Thorne (Aboriginal Community Support Worker – Koolin Balit) talks about his recent experience where advance care planning would have been of very real benefit.

Brochure: Advance Care Planing (English)

Pdf document about planning ahead for your future healthcare

Fact sheet: Advance care planning consumer information

A PDF document with information about advance care planning

Booklet: Take Control

A PDF document from the Office of the Public Advocate (OPA). This guide has information on medical treatment decision makers, advance care directives and enduring powers of attorney.

 2. Write it down

If there is something you feel strongly about you can write it down in an Advance Care Plan / Directive or in a letter describing your health care values and preferences for future medical treatments, including what type of medical treatment you would agree to, and what you would not want.

Booklet: Getting started workbook

A PDF document. This workbook will help you start thinking about a time when you may not be able to make your own decisions about your medical treatment, who you might want to make medical decisions for you and how to let them know what you would want.

a. Appoint a Medical Treatment Decision Maker (MTDM)

If you are ever unable to make medical decisions for yourself due to an injury or medical condition, the law states who can make decisions for you.  This is known as a medical treatment decision maker.  You can nominate or formally appoint someone you trust to make decisions about your healthcare on your behalf.

Form: Appointment of Medical Treatment Decision Maker

A PDF form you can fill in on your computer. This is the form you fill in to appoint someone as Medical Treatment Decision Maker on your behalf, if for some reason you are unable to make decisions about your medical treatment yourself.

Fact sheet: Checklist for appointing your medical treatment decision maker

A PDF document. This checklists tells you the decisions you should make and the steps you should take to fill in the above form and appoint your medical treatment decision maker.

In Victoria, if you are able to make decisions with support, you can legally appoint someone you trust (your Support Person) to assist you to access, or help you to access, health information relevant to your medical treatment decision making.

Form: Appointment of Support Person

A PDF form you can fill in on your computer. This is the form you fill in to appoint someone as a support person to help you to access health information about your medical treatment decision making

Fact sheet: Checklist for appointing your support person

A PDF document. This checklists tells you the decisions you should make and the steps you should take to fill in the above form and appoint your support person.

b. Complete an Advance Care Directive (ACD)

Writing down your preferences in an advance care directive, or in a letter describing your healthcare preferences, ensures your preferences and values are known to your medical treatment decision maker. If you do not have a medical treatment decision maker your advance care directive can help your healthcare practitioner know what is important to you.

Form: Advance Care Directive form

A PDF form you can fill in on your computer. This is the form you fill in to tell people about your health care values and preferences for future medical treatments, including what type of medical treatment you would agree to, and what you would not want.

Fact sheet: Instructions for Completing Advance Care Directive

A PDF document. This gives you instructions on how to fill in the Advance Care Directive form.

Booklet: Take Control

A PDF document from the Office of the Public Advocate (OPA). This guide has information on medical treatment decision makers, advance care directives and enduring powers of attorney.

Make sure that your medical treatment decision maker has a copy of anything that is written.  It would be useful to also give this information to your GP/doctor, even if you don’t complete a formal ACD which is signed off by the GP/doctor.

Making medical decisions for another person who lacks capacity to plan for their future medical treatment

A person who lacks capacity to complete an Advance Care Directive, or other advance care planning document for themselves, may have known values and preferences for future healthcare.  These preferences and values may have been: (i) communicated verbally; (ii) inferred from the way the person has lived their life and made other decisions; or (iii) based on observations about how they cope with their health issues and medical interventions.
These preferences and values can be recorded, by one or more people who know the person well, in the form, ‘What I understand to be the person’s preferences and values’. Note: this form is not an Advance Care Planning document.

This form records information about a person who cannot make medical decisions or express their preferences about medical treatment.  What is written in this form will help the Medical Treatment Decision Maker and health professionals to make medical decisions that the person would want.

Consumer Guide – Making decisions for another person

A PDF document from the Office of the Public Advocate (OPA). This guide has information to help people who are making medical decisions on behalf of someone else.

Preferences and Values form for another person

A PDF form that can be printed and filled in. This contains information to help people who are making medical decisions on behalf of someone else, and a form to record those decisions.

Future planning in the time of COVID-19

Recently, there have been temporary legislative changes that allow for enduring powers of attorney to be to be electronically signed and witnessed with all persons in separate spaces connected by audio-visual link. Advance care directives and appointments of medical treatment decision makers, however, cannot be witnessed remotely.

Future planning in the time of COVID-19 

A link to the Office of the Public Advocate’s website with information about what to think about when planning for your future medical care.

Sharing your documents

Sharing you Advance Care Planning documents with your health service/provider is important. It ensures that they are accessible when required, informing medical staff of your preferences regarding medical treatment and who you have appointed to make medical decisions on your behalf (if you become unable to do this yourself).  To have your documents lodged on your Monash Health medical records please follow the instructions outlined in this document.

Lodging Advance Care Planning document with Monash Health

A PDF fact sheet with instructions on how to share your advance care planning documents with Monash Health.

Need further assistance?

For the public

Monash Health Advance Care Planning Program offers a free service to assist you in advice, discussion and document preparation.

To arrange an appointment or for further assistance:

Information for services and organisations

Please contact the Advance Care Planning program if you would like to arrange an information session for your service/organisation.

Referral to Advance Care Planning

If you have a patient/client who would like to access the service, please send a referral to the Advance Care Planning Program, or contact our office:

Monash Health Advance Care Planning Referral Form

A PDF referral form which can be printed out and filled in.

Monash Health Advance Care Planning Referral Guidelines

A PDF document with guidelines on when to refer patients to Monash Health Advance Care Planning and what should be included with the referral.

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