Your guide to advance care
planning in Western Australia
A workbook to help you plan for
your future care
Your guide to advance care planning in Western Australia
|
B
© Department of Health, State of Western Australia (2022).
All information and materials in this Guide are protected by copyright. Copyright resides with
the State of Western Australia. Apart from any use permitted by the Copyright Act 1968 (Cth)
the information in this Guide may not be published, or reproduced in any material whatsoever,
without express permission of the WA Cancer and Palliative Care Network, Western
Australian Department of Health.
Suggested citation
Department of Health, Western Australia. Health professional guide for advance care
planning. Perth: Health Networks, Department of Health, Western Australia; 2022.
Important disclaimer
The information in this Guide is not intended to be comprehensive. Similarly, it is not intended
to be, nor should it be, relied upon as a substitute for legal or other professional advice.
If you have a legal problem, you should seek independent legal advice tailored to your
specic circumstances.
Interpreting service
Please ask for an interpreter if you need help
to speak to a health service in your language.
A workbook to help you plan for your future care
|
01
Contents
My future care 02
What is advance care planning? 02
Why is advance care planning important? 03
How can advance care planning help me? 04
Activity 1. What is your current situation in life? 05
What is involved in advance care planning? 06
1. Think 07
What matters most to me now?
What will matter most to me if I become less well in future? 07
Activity 2: Values, beliefs and preferences 07
2. Talk 11
Who can I talk to about advance care planning? 11
What are some things to talk about? 12
Activity 3: Talking 13
3. Write 15
Advance care planning and other related documents 15
Who will make decisions for you if you cannot make your own? 19
Activity 4: Is there an advance care planning document(s)
that is right for me? 22
4. Share 24
Where should I store my advance care planning documents? 24
Who should I share my advance care planning document(s) with? 24
Activity 5: Who has a copy of my advance care planning
document(s)? 25
Checklist of where the original copy of my advance care
planning document(s) is kept? 26
Where to get help 27
Acknowledgements 29
Your guide to advance care planning in Western Australia
|
02
This Workbook is an introduction to advance care planning. It includes
activities to guide you through the advance care planning process.
My future care
What is advance care planning?
Many of us want to have a say
in what type of care we receive
in our lives, particularly at times
when we are unwell and may
be unable to communicate
our wishes.
Advance care planning involves
talking about your values,
beliefs and preferences with
your loved ones and those
involved in your care.
Advance care planning:
is a voluntary process
is focused on what is most important to you
is respectful of your beliefs, values and culture
is best started when you are feeling well and able to make decisions
can involve as many, or as few, people as you choose
works best when you are open about what is important to you –
even though for some people this can be challenging
is a exible ongoing process that allows you to make and change
decisions as your situation, health or lifestyle changes.
Denition of advance care planning
A voluntary process of planning
for future health and personal care
whereby the persons values, beliefs and
preferences are made known to guide
decision-making at a future time when
that person cannot make
or communicate their decisions.
Source: National Framework for
Advance Care Planning
A workbook to help you plan for your future care
|
03
Why is advance care planning important?
Advance care planning can help you:
think through and plan what you want for your future and share
this plan with others
describe your beliefs, values and preferences so that your future
health and personal care can be given with this in mind
take comfort in knowing that someone else knows your wishes just in
case a time comes when you are no longer able to tell people
what is important to you.
Advance care planning can also be helpful for families and health
professionals:
Families of people who take part in advance care planning say they feel less
anxious, depressed and stressed and are more pleased with care received.
For healthcare professionals and organisations, it lessens unneeded
hospital stays and unwanted treatments.
Your guide to advance care planning in Western Australia
|
04
Talking with my loved ones and health professionals
about what might happen as my condition progresses
may help me and them understand the care I do or do
not want in future.
How can advance care planning help me?
Starting advance care planning is a personal decision. It can be useful to start
by thinking about how advance care planning could help you. Here are some
examples based on what other people have found useful.
Figure 1. Examples of how advance care planning has helped people
Sharing what is important to me may help my health
professionals or family make decisions about my care if
something unexpected happens in future.
I’m healthy, in my 20s and have a young family.
I have my nances in order but who will look after me
if I become unwell? It would be helpful to talk to others
about where I want to live and what will be important to
me if my health deteriorates.
I’m 61, have no children and my partner is a lot older than me.
I have just been diagnosed with a life-limiting condition.
I want to make decisions about where I want to live, and
who I want around me when I move. I might start with
talking to my GP about my future care and treatment
needs and see what support is available to me.
I will soon be moving to a residential care facility.
Do any of these
situations
apply to you?
A workbook to help you plan for your future care
|
05
Activity 1. What is your current situation in life?
Use the space below to write down your thoughts on your current situation in
life (for example your age, health and family situation):
Your guide to advance care planning in Western Australia
|
06
What is involved in advance care planning?
Advance care planning involves four main elements:
• think
• talk
• write
• share.
These elements are described in the picture below.
The Workbook includes various activities to help you work through these
elements.
Figure 2: Advance care planning model
A workbook to help you plan for your future care
|
07
1. Think
What matters most to me now? What will matter most to
me if I become less well in future?
Your advance care planning process will be guided by you. A good place to start
is to think about your values, beliefs and preferences. This may help you to work
out what matters most to you in relation to your health and personal care.
Activity 2: Values, beliefs and preferences
The following questions may help you think about your values, beliefs and
preferences. There are no wrong answers to these questions.
What does ‘living well’ mean to you?
Spending time with family and friends
Living independently
Being able to visit my home town, country of origin,
or spending time on country
Being able to care for myself (e.g. showering, going to the toilet,
feeding myself)
Keeping active (e.g. playing sport, walking, swimming, gardening)
Enjoying recreational activities, hobbies and interests
(e.g. music, travel, volunteering)
Helpful resources:
Visit the My Values website
Call Palliative Care WA 1300 551 704 (Monday to Thursday)
General queries and support on advance care planning
Find out about free advance care planning community workshops
Receive a set of What Matters Most cards
Call Palliative Care Helpline 1800 573 299
(9am to 5pm every day of the year)
Information, resources and support on any issues to do with advance
care planning, palliative care and grief and loss
Your guide to advance care planning in Western Australia
|
08
Practising religious, cultural and/or spiritual activities
(e.g. prayer, attending religious services)
Living according to my cultural and religious values
(e.g. eating halal foods)
Working in a paid or unpaid job
Other (use the space below to write down other things that are important)
Your life
What are the most important things to you in life?
(e.g. family, nancial security, health, travel)
Do you have any worries about your future?
A workbook to help you plan for your future care
|
09
Your current health
Does your health affect your day-to-day life or stop you doing things you like to
do? If so, how?
Your future health
If you become unwell / more unwell in future, what worries you most about what
might happen? (e.g. being in pain, not being able to make decisions, not being
able to care for yourself)
Your guide to advance care planning in Western Australia
|
10
Managing your future health
If you become unwell / more unwell in future, what will be important to you?
Think about:
Who you would like around you
Which people know enough about you to make decisions for / with you
Where you would like to receive your care
What would give you comfort (e.g. having pain managed, practicing cultural and
religious traditions, music, objects of signicance such as favourite photos)
Remember that you
can review and change any of
your choices and documents to suit
changes in your personal situation,
health or lifestyle.
A workbook to help you plan for your future care
|
11
2. Talk
Talking about advance care planning is a way of letting your loved ones and
those involved in your care know what you do and do not want to happen with
your future health and care. A close or loving relationship does not always mean
someone knows what is important to you. Having a conversation can be very
important.
Who can I talk to about advance care planning?
You might want to discuss what is important for you with people you trust.
This may include:
family
friends
carer(s)
enduring guardian (if appointed)
GP or another member of your healthcare team.
Your guide to advance care planning in Western Australia
|
12
Conversation starters
Ideas to help you start
What are some things to talk about?
You may want to share your values, beliefs or preferences for when you are
unwell as a way of letting people know what it is important to you. Here are
some conversation starters that can help you when talking to others.
Source: Advance Care Planning Australia
Talking with people close to you about what
might happen if you become unwell in future
may not be easy. You may feel uncomfortable
sharing your wishes. Your family and friends
may also feel nervous or upset talking about a
time in future when you may be unwell.
Some people also nd that family and friends
have their own opinions about what you
should include in an advance care plan. While it may be helpful to hear what
other people think, remember that you should decide what is best for you.
Refer to the Where to get help section for a list of services who you can talk to
about advance care planning.
Other useful resources
Advice on starting the conversation from Advance Care Planning Australia
Dementia Australia Start2talk
Take your time - remember
that advance care planning
is an ongoing conversation
and you do not need to talk
about everything at once.
A workbook to help you plan for your future care
|
13
Activity 3: Talking
Start by thinking about who you want to talk to about your future health care.
People you want to talk to:
When might be a good time to have a conversation? You might want to think
about the right time (e.g. this year, before your next specialist appointment, before
your next birthday). It may also be helpful to think about where you would like to
have the conversation (e.g. by phone, over dinner, while out walking).
Conversation starters you might use:
Opportunity Example
Financial planning
around retirement
As we get closer to retirement, maybe we should start
thinking about how we are going to spend our money and
where we want to live. It might be a good idea for us to
make a plan in case one or both of us becomes unable to
make important decisions in future.
Medical check-ups
“I’m seeing my GP next week for my yearly check-up.
There are a few things I want to discuss with the doctor.
I know that in future I may need to make some decisions
about my healthcare. It would be good to talk to you
about this as well as the GP.
Other useful resources
· Advice on starting the conversation from Advance Care Planning Australia
· Dementia Australia Start2talk
Your guide to advance care planning in Western Australia
|
14
Opportunity Example
Death of a friend
or relative
After seeing (our family member / friend)’s experience
as he reached the end of his life, it has made me think
about the sort of care I’d like in future. Can we spend
some time talking about this? Perhaps we could write
down some thoughts about what’s important to us and
then chat about it.
“I felt really comforted that (our family member / friend)’s
wishes about how she wanted to die were listened to
by the family and her doctors. It’s made me think about
what’s important to me and I’d like to know what’s
important for you. Can we have a chat about this? Maybe
we could write a few things down so we know what will
be important for us when we reach that point in future”.
Movies or news
items in the media
“It was so sad to see what that person went through
at the end of her life because nobody knew what she
would have wanted. I’d hate that to happen to us so
can we have a conversation about what would be
important to us?”
What are the top three things you would like to cover during this conversation?
1.
2.
3.
Remember that you
can review and change any of
your choices and documents to suit
changes in your personal situation,
health or lifestyle.
A workbook to help you plan for your future care
|
15
3. Write
Once you have thought about what is important to you and talked with others, it is
a good idea to write down what you decide.
There are several different documents used for advance
care planning in WA. Some are legal documents (i.e. Advance Health Directive
and Enduring Power of Guardianship). Others are more informal (i.e. My Values
andPreferences Form: Planning for my future care).
Some documents are written by you and others are completed by others on your
behalf.
You do not have to use any of these documents, but they can be helpful in
different situations. Thinking about what is important to you will help you decide
which one(s) could be useful for you.
Advance care planning and other related documents
To help you understand when you might use different documents for advance
care planning, you can think of them in the following way:
Documents related to
your health and care
Values and Preferences Form:
Planning for my future care
Advance Health Directive
Enduring Power of Guardianship
Organ and tissue donation
Documents related to
estate and nancial
matters
Making a Will
Enduring Power of Attorney
Documents that may
be completed by others
on your behalf
Goals of Patient Care
Advance Care Plan for someone with
insufcient decision-making capacity
Each of these documents is described on the following pages.
Your guide to advance care planning in Western Australia
|
16
Documents related to your health and care
Values and Preferences Form: Planning for my future care
Type of document: Informal
What it is: A record of your advance care planning
discussions.
Why it is useful: To let people know your values, preferences
and wishes. Your wishes may not necessarily be health
related but will guide treating health professionals, enduring
guardian(s) and/ or family as to how you wish to be treated
including any special preferences, requests or messages.
What is included: Questions are the same as the ‘Values’
section of the Advance Health Directive (see below). If you are not yet ready to
complete a full Advance Health Directive with formal witnessing and signing
requirements, you may like to start with completing this Form.
Enduring Power of Guardianship (also called an EPG)
Type of document: Legal
What it is: A legal document that authorises a person to make
important personal, lifestyle and treatment decisions on your
behalf. You can choose the person who undertakes this role.
This person is known as an enduring guardian or Health and
lifestyle decision maker.
When it is used: An Enduring Power of Guardianship is only
used if you become unable to make decisions or tell people
what you want.
What is included: An enduring guardian could be authorised to make decisions
about things such as:
where you live
the support services you have access to
the treatment(s) you receive.
An enduring guardian cannot make property or nancial decisions on your behalf.
Thumbnail
of doc that
link to online
version (when
avail)
Thumbnail of
doc that link to
online version
(image from pg
49)
Enduring Power of Guardianship
This Enduring Power of Guardianship is made under the Guardianship and Administration Act 1990
Part 9A
on the
________________________________________________
day of
__________________________________________________
20
_______
by (appointor’s full name)
______________________________________________________________________________________________
of (appointor’s residential address)
____________________________________________________________________________________
______________________________________________________
born on (appointor’s date of birth)
______________________________
This Enduring Power of Guardianship has effect, subject to its terms, at any time I am unable to make
reasonable judgments in respect of matters relating to my person.
1 Appointment of enduring guardian(s)
1A
Sole enduring guardian
I appoint (appointee’s full name)
_______________________________________________________________________________________
of (appointee’s residential address)
___________________________________________________________________________________
___________________________________________________________________________________________
to be my enduring guardian.
1B
Joint enduring guardians
I appoint (appointee’s full name)
_______________________________________________________________________________________
of (appointee’s residential address)
___________________________________________________________________________________
_______________________________________________________________________________________________________________________________
and (appointee’s full name)
______________________________________________________________________________________________
of (appointee’s residential address)
___________________________________________________________________________________
____________________________________________________________________________________
to be my joint enduring guardians.
2 Appointment of substitute enduring guardian(s)
I appoint (appointee’s full name)
_______________________________________________________________________________________
of (appointee’s residential address)
___________________________________________________________________________________
____________________________________________________________
to be my substitute enduring guardian in substitution of
(enduring guardian’s name)
______________________________________________________________________________________________
I appoint (appointee’s full name)
_______________________________________________________________________________________
of (appointee’s residential address)
___________________________________________________________________________________
____________________________________________________________
to be my substitute enduring guardian in substitution of
(enduring guardian’s name)
______________________________________________________________________________________________
My substitute enduring guardian(s) is (are) to be my enduring guardian(s) in the following circumstances:
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Signing each page is not compulsory but may provide a safeguard against pages being substituted. Signature of
(appointor)
_____ ___________________________
(witness 1)
_____ ___________________________
(witness 2)
_______________________________
OR
1
Thumbnail of
doc that link to
online version
(when available)
A workbook to help you plan for your future care
|
17
Advance Health Directive (also called an AHD)
Type of document: Legal
What it is: A record of your decisions about the treatment you
want or do not want to receive if you become unwell or injured
and are unable to make or communicate decisions. If this
happens, your Advance Health Directive becomes your ‘voice’.
When it is used: An Advance Health Directive is only used if
you become unable to make or communicate decisions or tell
people what you want. It can only be used if the information in
it is relevant to the treatment / care you require.
What is included: You decide what decisions and what treatments you want to
include. The term ‘treatment’ includes medical, surgical and dental treatments. It
also includes palliative care and measures such as life-support and resuscitation.
Tip: You can have both an Advance Health Directive
and an Enduring Power of Guardianship.
Organ and tissue donation
People can register to donate organs and tissue when they die. It is important
they talk to family, as relatives will be asked to agree. Organ and tissue donation
can only formally be registered at Donate Life.
Documents related to estate and nancial matters
Making a Will
A Will is a written, legal document that says what a person wants to do with
their money and belongings when they die. Visit the Public Trustee for more
information.
Enduring Power of Attorney (also referred to as EPA or Financial decision maker)
Type of document: Legal
What it is: An agreement that enables a person to appoint
a trusted person or people to make nancial and property
decisions on their behalf.
When it is used: Can only be used by a person older than 18
years. An Enduring Power of Attorney can only be made when
a person is still able to make and communicate their own
decisions.
24 25
Enduring power of attorney
This enduring power of attorney is made under the Guardianship and Administration Act 1990
Part 9
on the
_______________________________________________________
day of
__________________________________________________
20
_______
by (donor’s full name)
__________________________________________________________________________________________________
of (donor’s residential address)
________________________________________________________________________________________
_________________________________________________________
born on (donor’s date of birth)
______________________________
Sole attorney
I appoint (attorney’s name)
____________________________________________________________________________________________
of
_______________________________________________________________________________________________
to be my sole attorney.
Joint attorneys
I appoint (attorney’s name)
____________________________________________________________________________________________
of
___________________________________________________________________________________________________________________________
and (attorney’s name)
_________________________________________________________________________________________________
of
________________________________________________________________________________________
JOINTLY to be my attorneys.
Joint and several attorneys
I appoint (attorney’s name)
____________________________________________________________________________________________
of
___________________________________________________________________________________________________________________________
and (attorney’s name)
_________________________________________________________________________________________________
of
___________________________________________________________________________________________________________________________
JOINTLY AND SEVERALLY to be my attorneys.
OR
OR
1 Appointment of attorney(s)
Signing each page is not compulsory but may provide a safeguard against pages being substituted. Signature of:
(
person making the power)
_____ ________________________________
(witness 1)
_____ _______________________
(witness 2)
______________________________
1
A Guide to Western Australias
Advance Health Directive
Your guide to advance care planning in Western Australia
|
18
Documents that may be completed by others on your behalf:
Goals of Patient Care (GoPC)
Type of document: Clinical
What it is: A document written by a health professional to record information
about the decisions you and your healthcare team have made about the
treatment and care that is most appropriate for you based on your health and
what is important for you.
When it is used: A Goals of Patient Care document is written by a health
professional after a ‘goals of care’ discussion between you, your doctor / other
members of your healthcare team and your family or carer(s).
What is in it: You and the members of your healthcare team decide what goes into
your Goals of Patient Care document. The document records which treatments
will be used if you become very unwell and are unable to make or communicate
decisions
Advance Care Plan for someone with insufcient decision-making capacity
Type of document: Informal
What it is: An advance care plan used to guide health
professionals, enduring guardians and close family and
friends when making medical treatment decisions on behalf
of a person who does not have an Advance Health Directive.
When it is used: This document can only be used when a
person is no longer able to make their own decisions. It can
be completed by a recognised substitute decision-maker(s)
who has a close and continuing relationship with the person
receiving care.
What is in it: This form allows you to provide information about the values and
preferences relating to future medical treatment for a person who has lost the
capacity to make their own decisions. The information provided in this form
should be guided by the persons past choices and decisions, and any known
values and preferences. This form cannot be used to give legal consent to, or
refusal of treatment.
This is an advance care plan for a person with insucient decision-making capacity to complete an
advance care direcve¹. This is not a form that is able to give legally-binding consent to, or refusal
of treatment. This plan can be used to guide substute decision-makers and clinicians when making
medical treatment decisions on behalf of the person, if the person does not have an advance care
direcve.
What is advance care planning?
A process of planning for future health care, for a me when the person is no longer able to make
their own health care decisions. It relates to a person’s future health care and medical treatments.
It may include conversaons about treatments they would or would not like to receive if they
become seriously ill or injured. It includes idenfying the person they want to make these decisions
and how they want those decisions to be made. It has many benets for the person (care aligned
with preferences), loved ones and treang clinicians.
When should this form be completed?
This form should only be completed if the person no longer has sucient decision-making capacity to
make or communicate their medical treatment decisions. This form is available for use in all Australian
states and territories, however the Australian Capital Territory, Queensland, and Victoria have exisng
recommended forms, see Table 1.
This form is not intended to replace or revoke a legally-binding advance care direcve. If the person
does have decision-making capacity, they should consider compleng an advance care direcve.
The voluntary compleon of an advance care direcve, when the person sll has decision-making
capacity, is preferable over the compleon of an advance care plan¹. The relevant advance care
direcve form from each state and territory is available at:
www.advancecareplanning.org.au/create-your-plan
Who should complete this form?
This form should be completed by a person’s recognised substute decision-maker(s), assigned
to the role by law or appointed by the person to make medical treatment decisions, see Table 2.
They should have a close and connuing relaonship with the person. It is intended that this form
will assist substute decision-makers and the treang team to make medical treatment decisions that
align with the decisions the person would have made in the same circumstances. This informaon can
be used in aged care, community, or hospital sengs.
Advance care plan for a person with insucient decision-making capacity
Instrucon Guide: page 1 of 3 www.advancecareplanning.org.au
Instrucon Guide
A workbook to help you plan for your future care
|
19
Who will make decisions for you if you cannot
make your own?
Health professionals must follow a certain order when seeking a decision
about treatment for a person who is unable to make decisions or tell people
what they want.
This is called the Hierarchy of treatment decision makers.
It is important you understand who may be making decisions for you and this
may help you decide which advance care planning documents you need.
For example:
If you have an Advance Health Directive, then that will be used to guide
treatment decisions for you.
If you do not have an Advance Health Directive, then your enduring
guardian would be asked to make treatment decisions on your behalf.
If you do not have an Advance Health Directive or and enduring guardian,
then your spouse or de facto partner would be asked to make treatment
decisions on your behalf.
Your guide to advance care planning in Western Australia
|
20
Guardian with authority
Advance Health Directive
Decisions must be made in
accordance with the AHD unless
circumstances have changed or
could not have been foreseen
by the maker.
Enduring Guardian with authority
Parent
Spouse or de facto partner
Adult son or daughter
Sibling
Primary unpaid caregiver
Other person with close personal relationship
1
2
3
4
5
6
7
8
9
Hierarchy of treatment decision makers
Where an AHD does not exist or does not cover the treatment
decision required, the health professional must obtain a decision
for non-urgent treatment from the rst person in the hierarchy who is
18 years of age or older, has full legal capacity and is willing
and available to make a decision.
A workbook to help you plan for your future care
|
21
Tip
Your answers to the activities in this Workbook may help you to ll in
the required information in some advance care planning documents.
The ‘Where to get help’ section lists services to support you to
complete advance care planning documents.
More Information
The Ofce of the Public Advocate has more information on who can
make decisions for you if you cannot make your own.
Your guide to advance care planning in Western Australia
|
22
I could:
make a Will, and / or
appoint an Enduring Power of Attorney.
I want to make sure my nances and assets are in order.
I could:
make an Advance Health Directive to record
my treatment decisions, and / or
appoint an Enduring Guardian and share my preferences.
I have strong views on the treatment(s) I would / would
not want to receive in future.
Can you relate to any of the following statements?
I could:
complete a Values and Preferences Form, and / or
appoint an Enduring Guardian who knows me well
and I believe would make decisions on my behalf in
the same way I would make.
I have strong values and beliefs on the care I would
/ would not want to receive in future, but I am not
ready to make decisions about specic treatments
I do or don’t want.
Activity 4: Is there an advance care planning
document(s) that is right for me?
Your decision about which advance care planning documents, if any, are right
for you starts with a question about whether you want to make a record of
things that are important to you to guide your future treatment and care.
A workbook to help you plan for your future care
|
23
If you are still unsure whether any of these documents are right for you, you can:
talk to friends or loved ones, or to health professionals involved in your care
call Palliative Care WA 1300 551 704 (Monday to Thursday)
General queries and support on advance care planning
Find out about free advance care planningcommunity workshops
Receive a set of What Matters Most cards
call Palliative Care Helpline 1800 573 299
(9am to 5pm every day of the year)
Information, resources and support on any issues to do with advance care
planning, palliative care and grief and loss
seek specic advice from a relevant organisation (see Where to get help).
Remember that you
can review and change any of
your choices and documents to suit
changes in your personal situation,
health or lifestyle.
Your guide to advance care planning in Western Australia
|
24
4. Share
Once you have written down your preferences and wishes, it is important that
people close to you know where to nd the information.
Where should I store my advance
care planning documents?
If you have written an advance care planning document(s), you should keep the
original in a safe place.
You can also store a copy online using My Health record
(register and upload your advance care planning document).
Who should I share my advance care planning
document(s) with?
You may choose to give a copy of your advance care planning document(s)
with your:
family, friends and carers
enduring guardian (EPG)
GP / local doctor
specialist(s) or other health professionals
residential aged care home
local hospital.
Make a list of the people who have a copy of your current advance care planning
document(s). This will be a good reminder of who to contact if you decide to
change or revoke your document(s) in future. Use the checklist on the next page.
If you decide to make an Advance
Health Directive you can carry:
an Advance Health Directive (AHD)
alert card in your purse or wallet - 
you can order an AHD alert card
by contacting the Department of
Health Advance Care Planning
Line on (08) 9222 2300 or email
aMedicAlertbracelet.
Remember that you
can review and change any of
your choices and documents to suit
changes in your personal situation,
health or lifestyle.
A workbook to help you plan for your future care
|
25
Activity 5: Who has a copy of my advance care planning
document(s)?
They have a copy of my:
Details
Values and
Preferences
Form
Advance
Health
Directive
Enduring
Power of
Guardianship
Enduring
Power of
Attorney
Will
Who else has a copy?
My Family, friends
and carers
Person 1
Name:
Contact details:
Person 2
Name:
Contact details:
My enduring
guardian(s)
Person 1
Name:
Contact details:
Person 2
Name:
Contact details:
My Health professionals
GP
Name:
Contact details:
Specialist/ health
professional 1
Name:
Contact details:
Specialist/ health
professional 2
Name:
Contact details:
Residential aged
care facility
Facilty name:
Contact details:
Local Hospital
Hospital name:
Contact details:
Online versions
My Health Record
Other
Your guide to advance care planning in Western Australia
|
26
Checklist of where the original copy of my advance care
planning document(s) is kept?
Document Location of the original copy
My Values and
Preferences Form
Advance Health Directive
Enduring Power of
Guardianship (EPG)
Enduring Power of
Attorney (EPA)
Will
A workbook to help you plan for your future care
|
27
Where to get help
Advance care planning
WA Department of Health
(Advance Care Planning Information Line)
General queries and to order advance care planning resources and
documents (e.g. Advance Health Directives, Values and Preferences Form)
Phone: 9222 2300
Email: [email protected].au
Palliative Care WA
General queries and support on advance care planning
Find out about free advance care planning community workshops
Receive a set of What Matters Most cards
1300 551 704 (Monday to Thursday)
Palliative Care Helpline
Information, resources and support on any issues to do with advance care
planning, palliative care and grief and loss
1800 573 299 (9am to 5pm every day of the year)
Advance Care Planning Australia (ACPA) Free Support Service
General queries and support with completing advance care planning
documents
Phone: 1300 208 582
Online referral form: www.advancecareplanning.org.au/about-us
Medical advice
See your doctor.
Enduring Powers of Guardianship and Enduring Powers of Attorney
Ofce of the Public Advocate
Enduring Powers of Guardianship and Enduring Powers of Attorney –
for people with capacity
Guardianship and Administration queries – for people who may lack capacity
Phone: 1300 858 455 (local call rates from land line only).
Email: [email protected].au
Your guide to advance care planning in Western Australia
|
28
Professional trustee and asset management services
Public Trustee
Phone: 1300 746 116 (New enquiries and appointments)
Phone: 1300 746 212 (Represented Persons)
General legal advice
The Law Society of Western Australia
Phone: (08) 9324 8652
Find a Lawyer referral enquiry section
Community Legal Centres
Phone: (08) 9221 9322
Website for locations and contact details: www.communitylegalwa.org.au
Legal Aid Western Australia
Phone: 1300 650 579
Open Mon to Fri 9am to 4pm (Australian Western Standard Time).
Citizens Advice Bureau
Phone: (08) 9221 5711
Website: www.cabwa.com.au
A workbook to help you plan for your future care
|
29
Acknowledgements
We would like to sincerely thank all those who contributed to the development
of the Workbook, including the members of the Department of Health’s
Advance Care Planning Education Reference Group and the Consumer ACP
Resources Subgroup, who provided content expertise and guidance to shape
the document.
We would also like to thank those who participated in and provided feedback as
part of the consultation process.
We would like to acknowledge the following documents and resources which
informed the development of the Workbook:
Advance Care Planning Australia. Advance care planning explained.
Austin Health, August 2021.
Nous Group. National Framework for Advance Care Planning Documents.
Department of Health Australia, May 2021.
Palliative Care Australia. Dying to Talk Discussion Starter:
Working out what’s right for you. 2018.
Palliative Care WA. Advance care planning introductory model.
Perth, WA; PCWA ACP Consortium, 2021.
© Department of Health 2022
Copyright to this material is vested in the State of Western Australia unless otherwise indicated.
Apart from any fair dealing for the purposes of private study, research, criticism or review, as
permitted under the provisions of the Copyright Act 1968, no part may be reproduced or re-used
for any purposes whatsoever without written permission of the State of Western Australia.
This document can be made available
in alternative formats on request for
a person with disability.