Advance Care Planning

Make your wishes count – plan ahead for your healthcare needs and make your Advance Care Plan today.

What is Advance Care Planning?

Advance Care Planning (ACP) helps you think about, discuss and document your future health care wishes, in case there comes a time when you are unable to make decisions for yourself.

Peninsula Health offers a range of ACP support to help people at different stages of planning. Our service takes a person-centered and needs-based approach, ensuring people with complex or time-critical needs receive timely support, while others are supported to plan at their own pace using resources, education and guidance.

Why do I need an Advance Care Plan?

If you are sick or injured and cannot make your own decisions about treatment, your family may be asked to make decisions about your care, such as:

• resuscitation and life support
• high risk surgery
• permanent tube feeding
• hospital or nursing home admissions

Having an Advance Care Plan allows you to make these decisions ahead of time and discuss and write down your wishes.

Who can use the service?

This service is suitable for people who:

• Are aged 18 years or over who require assistance/support with advanced care planning
• Have a GP/Medical Specialist or be willing to visit a GP
• Have the capacity to make their own health care decisions

When should I start Advance Care Planning?

It’s never too early to start thinking about your Advance Care Plan. It is a good idea to plan when you are well and your health is stable. This gives you enough time to think clearly and talk about your preferences with your family and doctor.

We recommended that you begin to plan while:

• your health is stable
• you don’t feel under stress or pressure
• There is plenty of time to make well considered choices and to involve others such as your spiritual advisor, doctor, family, or friends.
• Benefits of Advance Care Planning
• Helps doctors and others who care for you know what you want
• Peace of mind of knowing your wishes will be respected
• Makes things easier for your family

Benefits of Advance Care Planning

• Helps doctors and others who care for you know what you want
• Peace of mind of knowing your wishes will be respected
• Makes things easier for your family.

Advance Care Planning helps to:

• Raise the topic about your future care preferences with family members who often wonder about such things but avoid raising discussion for fear of worrying loved ones
• Provide peace of mind that your wishes regarding future care and medical treatment will be respected by the doctors, nurses and others who may be looking after you
• Unburden your family of the stress and conflict that can happen while making decisions for a seriously ill loved one when there is uncertainty about their wishes
• Make your wishes and preferences clearly known so that these can be respected.

How will health providers know I have an Advance Care Plan?

• You can provide a copy of your Advance Care Plan to your GP, Specialist doctor and local public hospital through their Advance Care Planning program.
• You can also upload a copy to your national My Health Record – the Australian Government system for personal health information. This will allow healthcare providers like doctors, specialists, and hospital staff with access to the My Health Record system to see your Advanced Care Plan.

Dr Fergus McGee from Bayside Health Peninsula’s Advance Care Planning Service explains what the changes mean when it comes to making end of life care decisions. Make your wishes count by making an Advance Care Plan. 

How Advance Care Planning support works at Bayside Health Peninsula

ACP support at Peninsula Health is provided through different pathways, depending on individual needs and circumstances. Not everyone will need a one-on-one appointment with an ACP clinician to complete documents.

After a referral or enquiry, the team will help guide people to the most appropriate ACP support option.

 ACP support options

• Self-guided Advance Care Planning

Suitable for people living in the community who are independent and comfortable completing planning with guidance. Clients receive information, templates, and step-by-step guidance to support conversations with family, substitute decision-makers, and their GP.

• Group information sessions and drop-in support

Education sessions and drop-in clinics provide information about ACP, legal documents and what to consider when planning ahead. These sessions allow participants to ask questions and receive feedback on draft ACP documents.

• Clinician-led ACP appointments

One-to-one appointments with an ACP clinician are prioritised for people with advanced or deteriorating illness, complex medical or psychosocial needs, cognitive impairment, complex family dynamics, time-critical situations (including inpatient settings), or Voluntary Assisted Dying (VAD)-related ACP needs.

What to expect from an ACP referral

A referral to the ACP service does not always involve a one-to-one appointment to complete documents. ACP support may include:

• Education and information
• Guidance on starting ACP conversations
• Support to self-complete documents
• Review and clarification of draft documents
• Referral to clinician-led ACP support where required

This approach helps ensure timely access to ACP support for people with the most complex or urgent needs.

Referrals

Referrals to the ACP service may be made by health professionals or through self-referral. All referrals are reviewed, and the most appropriate ACP support pathway is identified. Where appropriate, people may be supported through self-guided or group-based ACP pathways.

Call us to explore these options: tel:1300665781

Working with your GP

General practitioners play an important role in Advance Care Planning. GPs can support early ACP conversations, review and sign Advance Care Directives where appropriate, and assist with ongoing care planning over time. The ACP service works alongside general practice to support people to document and review their future care wishes.

Resources

• Advance Care Planning Brochure
• Advance Care Directive for Adults
• Advance Care Planning Factsheet
• Advance Care Planning (health.vic.gov.au)
• Appointment of medical treatment decision-maker form long-interactive
• Medical Treatment Planning and Decisions Act 2016 (health.vic.gov.au)
• Office of the Public Advocate

Contact

For more information or to discuss which Advance Care Planning support option may be right for you, please contact the Advance Care Planning service.

Advance Care Planning Service
Phone ACCESS: 1300 665 781
Email: acp@phcn.vic.gov.au