By Maryanne Humphries
As a registered nurse now overseeing clinical teams in the aged care sector, I know exactly how emotionally challenging it can be for families who have to make critical healthcare decisions on behalf of their loved ones.
It’s made even harder when they’re having to second-guess whether the decisions they’re making are what their family member would want.
While many Australians discuss their healthcare preferences with family members, far fewer formalise those decisions in a legally binding document known as an Advance Health Directive.
According to Advance Care Planning Australia only six percent of Australians have completed an Advance Health Directive. For people over 65, the uptake is between 14 and 25 per cent.
Of those few Australians who have an Advance Health Directive, many do not know what to do with it. This can’t be a document left at the bottom of a drawer somewhere.
A person’s aged care provider and doctor should both have a copy to make sure it counts when the time comes. A copy should also be easily available in the home to anyone who might be caring for the person.
If something serious happens, such as a fall, a stroke or another medical emergency, the individual’s wishes need to be accessible at the exact moment decisions are being made.
An Advance Health Directive allows people to outline the types of treatment they would or would not want if they become unable to make decisions for themselves.
For example, a person may choose to receive treatments such as antibiotics but decline invasive interventions such as resuscitation, intensive care or life support measures.
In the past, I have witnessed people’s distress when they have woken up in the Intensive Care Unit with multiple tubes and wires attached to them. It can also be very distressing for the family having to say goodbye to their loved one in the middle of an ICU instead of at home.
The directive can also help honour a person’s preference to remain at home during the final chapter of life, rather than being transferred to hospital unnecessarily.
These directives provide critical guidance for family members who might otherwise be forced to make difficult decisions under enormous emotional pressure.
If wishes are clearly documented, the family does not have to carry the burden of guessing what their loved one would have wanted.
What is an Advance Health Directive?*
- An Advance Health Directive is a legal document capturing your wishes for future medical treatment in the event you’re unable to communicate or make decisions.
- It is important that your family, GP and aged care provider all have a copy of your directive so your wishes can be accessed quickly if an emergency occurs.
- It helps ensure your healthcare team understands the type of treatment you would want, and importantly, the treatment you would not want.
- The document can include specific instructions about matters such as resuscitation, intensive care, life support or hospital transfers.
- An Advance Health Directive may also nominate a trusted person to help make healthcare decisions on your behalf if you lose decision-making capacity.
- Each state has its own forms and legal requirements. To create a directive, search online for the document applicable in your state.
Maryanne Humphries is the Trilogy Care clinical governance lead. Trilogy Care is a home care provider that helps 15,000 older Australians to live independently in their homes.
*Source: Queensland Government
