Advance care planning
When faced with a life-limiting illness, some people think about what they’d like to achieve in the time they have left. Palliative care teams are experienced with helping patients and their families talk about their goals and preferences for care, and the amount of treatment they want for the cancer. This can involve difficult discussions about balancing the quality and length of life.
This process is called advance care planning. While it may be confronting, many people also find this process empowering. It can be started at any stage, whether you are feeling well or ill. It enables you to convey your preferences for your future health care if you become unable to communicate your wishes.
You and your family may find it very useful to start thinking about these issues before they are raised by a health professional. What matters to you most? Would you choose to have less time if it means feeling relatively well, or would you want as much time as possible even if treatment would lead to unpleasant side effects? Everyone has their own individual preferences and these will often change as your circumstances change.
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|Advance care planning doesn’t mean you have given up or will die soon. Your needs might change over time and it is a good idea to regularly review your plan. Palliative Care Australia has developed a discussion starter that can help you reflect on your preferences for care and talk about them with your family, carers and close friends. See dyingtotalk.org.au/discussion-starter.|
You can write down your wishes for your future medical care in what is known as an advance care directive. Depending on where you live, it may be called an advanced personal plan or advance health directive, and it is sometimes known as a “living will”. This document provides a record of your values and treatment preferences for doctors, family, carers and substitute decision-makers to consider if you become unable to communicate or make decisions. You can revise or cancel your advance care directive at any time. Ask your doctor or hospital to place your directive on your medical record. You can also save it online at myhealthrecord.gov.au.
You can legally appoint someone to make decisions for you if at some point in the future you’re not able to make them yourself. This can include decisions about your finances, property, medical care and lifestyle. A substitute decision-maker should be someone you trust and who understands your values and wishes for future care. Depending on where you live, the documents for appointing this person may be known as an enduring power of attorney, enduring power of guardianship, or appointment of enduring guardian or medical treatment decision-maker.
|Each state or territory has different laws about advance care planning. For more information about completing, changing or cancelling an advance care plan, call the Advance Care Planning Advisory Service on 1300 208 582, or visit advancecareplanning.org.au.|
Prof Katherine Clark, Clinical Director, Palliative Care, Northern Sydney Local Health District Cancer & Palliative Care Network, and Conjoint Professor, Northern Clinical School, University of Sydney, NSW; Richard Austin, Social Worker, Specialist Palliative Care Service, TAS; Sondra Davoren, Manager, Treatment and Supportive Care, McCabe Centre for Law and Cancer, VIC; A/Prof Brian Le, Director of Palliative Care, Victorian Comprehensive Cancer Centre – The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, VIC; Cathy McDonnell, Clinical Nurse Consultant, Concord Centre for Palliative Care, Concord Hospital, NSW; Natalie Munro, Team Leader, PalAssist, QLD; Penelope Murphy, 13 11 20 Consultant, Cancer Council NSW; Kate Reed, Nurse Practitioner Clinical Advisor, Palliative Care Australia; Merrilyn Sim, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. We particularly acknowledge the input of Palliative Care Australia and their permission to quote from €œBrian’s Story €_x009d_ in A Journey Lived – a collection of personal stories from carers (2005) on page 41. This booklet is funded through the generosity of the people of Australia.
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