Advance care planning

SpeakUp.logo.rev.colourRGBFrom the SA Advance Care Directives Project Team… You may be aware the new Advance Care Directives Act 2013 (SA) and changes to the Consent to Medical Treatment and Palliative Care Act 1995 and Guardianship and Administration Act 1993 come into effect on 1 July 2014. Together these changes pave the way for a rights-based, person-centred approach to decision-making for health care and other matters.

There will be a new Advance Care Directive Form on which a person can appoint a substitute decision maker and/or write instructions about their future healthcare, and their wishes for their living arrangements and personal matters.The new Advance Care Directive Form replaces the existing Medical Power of Attorney, Anticipatory Direction and Enduring Power of Guardianship with a single Advance Care Directive Form (however any of these existing forms will continue to have legal effect post 1 July 2014). ACD Fast Facts and ACD Form

This new Advance Care Directive applies at any time that the person has impaired decision-making capacity in relation to the decision– not just at end of life. The changes will also impact on who can consent to or refuse healthcare on a patient’s behalf, whether or not the person has an Advance Care Directive.

It is important that we all have some understanding of what this means for health practitioners. For more information about the changes to who can consent to health care for a person with impaired decision-making capacity, including Fact Sheets and Frequently Asked Questions, are available at: www.sahealth.sa.gov.au/advancecaredirective.

For quick reference we have put together a list of the key things you will need to know from 1 July 2014 (see attached). Our education and training materials provide more comprehensive information.

Education and training materials available
A range of education and training materials are available on the SA Health website to assist health practitioners understand the new Advance Care Directive legislation and changes to third party consent. These include fact sheets, Frequently Asked Questions, a training video and other relevant resources. To view these please visit www.sahealth.sa.gov.au/advancecaredirective

Advance Care Directive Form and DIY Kit
The Advance Care Directive Form and DIY Kit is available to the public from 1 July 2014, either in hard copy from Service SA or electronically from the Advance Care Directives website www.advancecaredirectives.sa.gov.au. A copy of the ACD Form has been included as an attachment to this email.

The Legal Services Commission can provide advice to the public on completing their Advance Care Directive Form and assistance with witnessing.

Public awareness
SA Health is also undertaking advertising to inform the public of the new legislation and encourage uptake of the new Advance Care Directive Form. The advertising includes metropolitan and regional newspapers, radio and online. The advertising commenced on 26 June and will run until then end of August 2014. Spread the word if you can. For more information about Advance Care Directives please visit www.advancecaredirectives.sa.gov.au

My thoughts on Advanced Care Planning is we should be having the discussion with our teenage children, around the time the learn to drive and vote. The decisions made by others, or by us, following a health crisis may not be made with enough rational thought, due to things like a diagnosis of a terminal illness, or a stroke or accident. Think about it today, and if you haven’t planned for your end of life, or your elderly parents have not made plans for their end of life, watch the video below and start the conversation.

Alzheimer’s Australia developed a website and tool called Start2Talk. It asks: What is ‘planning ahead’?

Planning ahead is thinking about your future, and putting things in place so that your choices will be known and acted on if you cannot express these choices yourself later in life.This may happen if you have a sudden accident, become very ill or develop a condition such as dementia that affects your memory and your planning ability. Planning ahead can include issues related to your finances, lifestyle or health care. This website will help you to plan ahead for your future. It is a practical and comprehensive resource for people across Australia just like you. It gives you the information you need to make decisions and helps you to put your decisions into action.

Finally, this video on YouTube, brought to my attention by a blog I follow Reflections on Dementia, Caregiving and Life in General is a powerful message about speaks to the heart about why everyone should think about their own Advanced Care plans. It reinforces the importance of this new legislation in South Australia.

 

14 thoughts on “Advance care planning

  1. If you have already blogged about what I am about to ask, then ignore it! “Living Well with Dementia” — the living well, I suppose is personal, but what are the general priniciples as far as you are concerned? It occurred to me after watching the above video that I need to think about what living well means to me.

    • Hi Alison, I have no idea if I have blogged specifically about living well, although hope that my blog implies/says I do my utmost to do that! Reviewing one’s own life and what living well means is so important, with or woithout a terminal illness; it is a pity it takes ageing or illness to get most of us to do it!!

      • I did a wee exercise on this and decided I could live in my bed happily so long as I had books, (someone to go to library) netbook, wifi, TV/dvd, fridge by bed and a professional to look after my intimate needs. Of course I am glibly assuming I can remember how all the gadgets work. Hmm. May need to re-write this one. Thanks, Kate. xx

      • It is an interesting exercise… I wasdown to “as long as I have books and music and pencil and notebook” if I get to the stage of not being able to work out using a pc… and then thought… ‘what about when I can’t write’ (which is on its way)?

      • It seems to me that if writing might go out of the window, it would be only fair if we were given an alternative skill–like painting/sketching/clay/craft of some kind? I have seen people having lots of fun with paint applications on ipads etc. So now I need to add large plastic bedcover to my essentials so that I can make as much mess as possible. I had forgotten about music (how could I?) My mum when she was virtually blind and very deaf and bedridden, still loved music and was fortunate that she lived with my brother who started every day with practising the most elegant pieces of Bach. Although she was an avid reader, when her eyesight (and she said her brain) gave out, she didn’t seem to miss reading. She insisted on having her favourite books (hymnbook and Housman poems close at hand even when she couldn’t see them. You know how lovely it is when you go on a short trip with just a couple of pieces of clothing and think how simple life is without all the stuff? Perhaps as people get older they just slough off the things they won’t need later on? I realise this is not necessarily helpful for someone living with dementia. On the other hand my sister spent a lot of her later working life exhausted and stressed and I really hope that she enjoys not having to make an effort and being cherished in a pretty house with kind people and Very Good Food. Sorry, rambling. X

      • Good point… although I think I have been given an alternative skill, at least fornow, which is writing poetry. Who knows what will happen when I can no longer type or put pen to paper… and rambling is good, the topic brings it out! xox

  2. Thanks for letting us know about the legislation Kate. To think that some states in Oz don’t even have any legislation!! I just wish that we had one piece of legislation that applied to all the states, and it wasn’t something that applied to each state individually. It would be much easier. Oh well.

  3. …..Advanced Care Directives are a brilliant idea, theoretically , and might be able to give someone false peace of mind……but from personal experience, they are currently not worth the paper they are printed on……

    …if the Public Trustee is used for all …’end of time circumstances’…and as the the Sole Executor……they are big enough and strong enough to withstand any ” family ” challenge……and this service is free !!….

  4. Thank you Kate, this is a very important message for all of us. I trained as a consultant for the Respecting Patient Program in 2004 while employed as a dementia consultant for an aged care group. I met with many, many residents and their families in an endeavour to encourage them to speak about, and document their future care wishes should they be unable to make decisions themselves. I found that while most residents were keen to speak about this subject, their family members were not. I guess that the issues that those family/ friends were coming to terms with – a family member or close friend with a diagnosis of a terminal illness and the responsibility of placing them into care was enough! Now being asked to participate in decisions relating to end of life issues was just too much to think about. I can relate to that having been in a similar position myself with my mother. However, in retrospect and with the benefit of many years of experience all I can say is ‘please face this issue – please talk about this sooner rather than later – this may be one of the finest gifts you can give someone you love’.
    Unfortunately, I think that laws relating to this area differ from state to state. A potential problem.

    • I think that the new Directives in SA are definitely going to be applicable no matter what state we need them, so this is a positive change… let’s hope the other states take the lead from SA.

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