Majority of older Australians ‘sidestepping’ end-of-life care

Paul Hayes

4/05/2021 3:16:27 PM

And most of the 30% with some form of advance care planning have documents that are incomplete, invalid or not legally binding, a new study finds.

Two middle-aged men having a serious discussion
Creating a legally binding advance care plan when people still have decision-making capacity is important.

Seven out of 10 Australians aged 65 and older are missing the opportunity to control their end-of-life care, with men less likely to plan than women, according to a new national study.
The government-funded study, led by Advance Care Planning Australia (ACPA), showed that among the 30% of older Australians with advance care planning documents, only 14% are legally binding advance care directives, which are considered the ‘gold standard’.
Advance care directives can only be completed by a person with decision-making capacity.
The study found the majority of documents among older Australians are plans where preferences are reported by either family members or healthcare professionals. While these documents can be used to guide care, they are not legally binding. 
According to ACPA Program Director Linda Nolte, this creates a situation in which many older Australians are leaving their end-of-life care in the hands of others.
‘We’re concerned for older people who expect to remain in control of their medical decisions as they age. If choice and control is important to you, advance care planning should be on your radar,’ she said.
‘An important part of healthy ageing is making informed healthcare choices. We urge people to take active steps to control their future care and create a legally binding advance care plan, while they still have decision-making capacity.
‘It means you’re more likely to get the care you want and avoid treatment you don’t want. It also relieves loved ones of the burden of making life-and-death decisions by guesswork.’
The Australian Digital Health Agency (ADHA) recently released a new set of national guidelines designed to assist healthcare providers support patients who want to add advance care planning documents to their My Health Record.
The guidelines, developed as part of the National Goals of Care Collaborative led by the ADHA and the Western Australian Department of Health, provide guidance about how to store and access documents related to advance care planning, and goals of care discussions that occur in the context of end-of-life care.
‘Advance care planning documents placed in the My Health Record will improve [patients’] accessibility to acute care clinicians and other health professionals at the time of need when important clinical decisions need to be made,’ Associate Professor Joel Rhee, Chair of RACGP Specific Interests Cancer and Palliative Care, previously told newsGP.
‘Enabling patients to personally upload these documents into My Health Record has been a step in the right direction.’
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