As health professionals, we know that health does not always run according to plan. Treatment may be needed when an individual is unable to participate in their own decision-making. This is especially true at the end of life with over 50 percent of people unable to voice their preferences at this time. Despite this fact, there is a continued absence of planning with only 15 per cent of Australians having formalised their wishes in an advance care directive.

Advance care planning aims to address this gap by asking us to consider three questions:

• If there is ever a time in our future when we are too sick to speak for ourselves, do we have someone we would trust to speak for us?
• What would we want them to say?
• Do they know?

Advance care planning involves planning for our future health care and nominating a trusted person to act as a substitute decision-maker if needed. In order to do this, we need to consider what matters most to us and how this may shape our view of acceptable treatment outcomes and quality of life.

Advance care planning is often associated with end-of-life care. This does the topic a disservice and restricts advance care planning from integrating into a normal aspect of routine health care. This can be seen through minimisation of the topic across primary health and chronic disease policy and a consistently low prevalence of advance care planning document completion.

Health professionals and care workers of all disciplines and backgrounds are well placed to prompt and assist the people to whom they are providing care or support. Here’s how to approach that process.

Be Open, Be Ready, Be Heard

Advance care planning is about being open to considering how we want to live. Encourage the person you are supporting to consider what this may look like for them, what gives them a sense of purpose and what makes life worth living. Sometimes it is easier for people to consider what an unacceptable quality of life may look like for them.

This information needs to be communicated to loved ones and the regular healthcare team, along with an identified substitute decision-maker. Documenting these preferences and legally appointing a substitute decision-maker is recommended to ensure everyone understands the person’s future health care preferences.

Completed advance care planning documents can be uploaded to My Health Record and copies can be shared with substitute decision-makers, family, friends, carers, hospitals and other health providers. This will enable documents to be accessed when they are most needed.

If the person you are supporting has reduced decision-making capacity, they can still be involved in the conversation as much as possible. Their preferences can be detailed by their substitute decision-maker in an advance care plan for a person with reduced decision-making capacity.

As health professionals, we have to be open to having these conversations - including with our own families. These conversation starters can assist.

It is never too early to start these conversations. Normalising these conversations means starting the conversation while the person is in good health, and continuing the conversation regularly. Starting advance care planning conversations early encourages all of us to have an ongoing awareness and insight into our own health and preferences, and the ability to have ongoing conversations as health needs or treatment options change.

Proactive participation of all health care workers, irrespective of discipline, is really needed. National Advance Care Planning Week, from 20 – 26 March, is the perfect time to learn more and start the conversations with the people you are supporting.

Visit advancecareplanning.org.au to access a free email starter pack, an Advance Care Planning Improvement Toolkit for workplaces and resources in 18 languages. You can also find events and online webinars available Australia-wide during National Advance Care Planning Week at acpweek.org.au.

For free advice and support, to make a referral or request a posted pack including relevant state documents, call the National Advance Care Planning Support ServiceTM on 1300 208 582 from 9am - 5pm (AEST/AEDT) Monday to Friday.

Advance Care Planning Australia TM  is funded by the Australian Government and administered by Austin Health.