Frequently Asked Questions
Q: Is it helpful to engage in Advance Care Planning?
A: One of the hardest situations for a doctor to face is to be called to a patient with a critical illness, when there is no plan in place. For some patients chronic illness such as dementia or disability due to stroke may have made their quality of life very poor. For others their quality of life might have been very acceptable to them right up to this illness. The problem is that the doctor has to decide whether to start invasive medical care in an attempt to save the patient, without knowing the person as an individual or what they would want. The next step is to call the person's family for guidance, but the family members often struggle to know what to do, or worse may disagree and argue. An Advance Care Plan allows you to have a say when you are critically ill. Otherwise you are trusting the decision to someone who does not know you. Advance Care Planning relieves the burden on your family, and guides medical decision making.
Q: Who do I talk to?
A: Talk to your family and to those most likely to be involved in making decisions if you are unable to speak for yourself. A close or loving relationship does not always mean that the other person knows or understands your wishes for future medical care. Talk to your doctors. They may assist you to make sure your Advance Care Plan is clear and complete. Give your doctors a copy of your completed Advance Care Plan or Directive.
Q: Who is Hunter New England Health's Advance Care Planning team?
A: Lisa Shaw and Kate Gunn are the Project Officers for the Advance Care Planning Unit. The Project Officers support all health care services in the Hunter New England Area Health Service in providing Advance Care Planning.
Q: Who should I choose to make decisions for me?
A: In NSW, there is a hierarchy that determines the person who is responsible for you. Both you and your 'person responsible' should have an understanding of the responsibility of medical decision making within this role. The person should be someone you trust, who will listen carefully to your values and wishes for future care, and someone who will be comfortable making decisions in difficult situations. If either you or your person responsible is not comfortable with the responsibility of being your medical decision maker, then you can appoint an Enduring Guardian. This process requires a legal officer to witness your signature. The Office of the Public Guardian has a booklet available called Enduring Guardianship in New South Wales: Your way to plan ahead. This booklet can provide more information about the process. You can download a copy of this booklet at http://www.lawlink.nsw.gov.au/opg.nsf/pages/enduringindex
Q: Do I need a lawyer to complete an Advance Care Plan or Advance Care Directive?
A: No. The law does not require you to have a lawyer to complete your Advance Care Plan or Directive. If you appoint an Enduring Guardian, this process does require a legal officer to witness your signature on the appointment document. It may be of benefit to you to have your GP/ Specialist Doctor review and witness your Advance Care Plan or Advance Care Directive so they can answer any questions you have about the benefits or burdens of medical treatment.
Q: Can my Advance Care Plan or Advance Care Directive be changed or revoked?
A: Yes. You can change your Plan or Directive at any time. If you change or revoke your Advance Care Plan or Directive, you need to inform your person responsible or enduring guardian that you have done so. If you have distributed copies of your Advance Care Plan or Directive to others, you should contact them to destroy the out of date copies. In NSW at present, Advance Care Plans and Advance Care Directives are 'strongly persuasive' of care preferences and are used to guide your person responsible or enduring guardian in their decision making on your behalf.
Q: When is an Advance Care Plan used?
A: It is only used if you are unable to make your own decisions, due to physical or mental incapacity. It would guide the decision making of your doctor, your person responsible or enduring guardian and family.
Q: What if I become ill or I am injured while I am away from home?
A: The best way to ensure that you receive the type of care you want is to discuss your choices with your person responsible or enduring guardian and family. Also, make sure that they have a copy of your Advance Care Plan or Directive.
Q: What happens in an emergency?
A: When there is an emergency and your medical record is not available, life-sustaining measures may be started. Following discussions with your person responsible or enduring guardian and family, treatment can be reviewed and modified if it is clear that it is not what you would have wanted.