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Most older Australians unprepared for end-of-life decisions

New research from Advance Care Planning Australia (ACPA) reveals that 70 percent of older Australians are without an Advance Care Directive, leaving no instructions in the event that they’re unable to make their own medical decisions.

Advance Care Planning Australia​ reveals over two thirds of older Australians are without an Advance Care Directive. (Source: Shutterstock)

Funded by the Australian Government, this landmark study was recently published by BMJ Open and is the largest and most comprehensive study into the prevalence of Advance Care Directives in Australia.

The study involved reviewing de-identified health records at the point-of-care in 51 Australian hospitals, aged care facilities and GP clinics, across six states and territories.

The study found that a third of people reviewed had an Advance Care Directive, which includes documenting preferences for care and appointing a substitute decision-maker.

“With Australia’s ageing population, it’s concerning that most older Australians are leaving it to chance and not taking active control of their future health care,” Medical Director of Advance Care Planning Australia, Dr Karen Detering says.

“Without a plan, older people may be left vulnerable and potentially without a voice. And far too often loved ones are left to blindly make decisions under the worst circumstances.

“As a medical practitioner I’ve witnessed these scenarios and I can tell you it’s a heartbreaking way to say goodbye to your loved ones.”

Advance care planning can reduce anxiety, depression and stress experienced by families and that they’re more likely to be satisfied with their loved one’s care. It helps prepare future health care at a time when you may no longer be able to communicate those decisions yourself.  

 Dr Detering says the findings are a great starting point to better understand the Australian advance care planning landscape.

“This valuable baseline data will be used to inform policy in advance care planning, which is becoming an increasing healthcare priority,” she says.

To increase public awareness, ACPA’s National Advance Care Planning Week initiative runs from 1 – 5 April 2019, encouraging all Australians to make sure their care preferences and values are heard and respected.


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