Call for overhaul to aged care with advance care planning

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The Older Persons Advocacy Network (OPAN) and Advance Care Planning Australia (ACPA) have called for older Australians to have more choice and control over their health and aged care planning decisions.

Both organisations are calling for advance care planning to be recognised as a fundamental component of quality aged care as National Advance Care Planning Week kicks off today.

Alarmingly, only 14 per cent of older Australians aged 65+ have completed an advance care directive (ACD)1. Yet around 30 per cent of us will be too unwell to make our own treatment decisions at the end of our lives2.

An ACD is a legal document outlining a person’s preferences and instructions for their future health care. The document comes into effect when a person is not capable of making their own treatment decisions, providing a sense of certainty, choice and control in the face of declining health.

However, advance care directives are only legal when completed and signed by people with decision-making capacity.

Advance care planning offers the best chance for us to live life on our own terms as we grow older and face more health challenges. It makes sense to plan ahead, rather than leaving it to chance and forcing loved ones to decide for you.

ACPA Program Director Linda Nolte explained, “Our national consultation and research revealed advance care directives are not currently part of routine care planning for older people. These advance care directives should outline preferences of care and/or appoint a substitute decision-maker. This situation needs to change.”

Currently the aged care system is under extreme pressure with the impacts of the COVID-19 pandemic, staff shortages and aged care reforms, and older people are facing those stressors directly.

Encouraging older people to develop advance care directives can mitigate many stresses they, their families and carers face at critical moments in their lives.

Craig Gear OAM, CEO OPAN said “Ensuring people have choice and control over health care decisions, now and into the future, is an important component of quality aged care and dignity and respect for our choices as we age.”

“Advance care directives are a vital addition to upholding the rights, the independence and the dignity of older people. OPAN would like to see the voluntary completion of advance care directives become a regular feature of planning ahead that will also ensure older people’s wishes are heard and upheld.”

“During the current process of reforming aged care, the rights of and respect for older people must be at the centre of any new Aged Care Rights Act. Advance care directives are one tool to ensure those rights and choices are front of mind.”

For older people in residential aged care, 30 per cent of residents had an advance care plan completed by someone else such as a family member or carer, rather than making these choices themselves3.

Ms Nolte stated, “It’s essential that we provide people the opportunity and support to plan earlier, while they still have capacity to make their own decisions and clearly express their own preferences and choices”.

OPAN and ACPA call for governments and care providers to do more to ensure advance care planning is part of routine aged care. The health and aged care workforce should be better supported to work with older people to identify their preferences and provide care that aligns with their preferences.

National Advance Care Planning Week is a great time to have the conversations that matter and document your values and preferences. Make your future health care your choice – and let those closest to you know your preferences.

To inform older people and the aged care sector on the necessity of advance care planning, OPAN and ACPA are partnering on a free webinar - Advance care planning is for everyone, from 11:30am – 12:30pm AEDT Tuesday 22 March. Register your interest here

Free information and support

Visit acpweek.org.au for more information, free email starter packs and to find face to face and online awareness-raising events Australia-wide. For free, personalised advice, call the National Advance Care Planning Support Service on 1300 208 582 from 9am - 5pm (AEST) Monday to Friday.

Call OPAN on 1800 700 600 for free and confidential aged care advocacy and support or visit opan.org.au. Aged care advocates stand by your side, working with you, to give you a voice and help you to resolve aged care issues. OPAN is independent from both government, and aged care providers.

Interview opportunities are available with OPAN CEO and ACPA Program Director and local ACPA ambassadors through the media contacts below.

Media Contacts

OPAN - Jane Polkinghorne – 0414 464 652 – jane.polkinghorne@opan.com.au

ACPA – Loretta Walshe - 0466 941 942 - loretta.walshe@austin.org.au

When reporting about older people please refer to OPAN’s media reporting guidelines and for more information or media enquiries visit OPAN’s Media Centre.

Important notice to media for stories relating to older people

It is critical to provide older people with an avenue to get support when covering stories about aged care. We strongly encourage you to include the following message in your story to enable older people to seek support:

For information or support regarding aged care, please call the Older Persons Advocacy Network on 1800 700 600 or visit opan.org.au


1. Buck K, Nolte L et al. Advance care directive prevalence among older Australians and associations with person‐level predictors and quality indicators.

2. Silveira MJ, Kim SY and Langa KM. Advance directives and outcomes of surrogate decision making before death. New England Journal of Medicine. 2010; 362: 1211-8.

3. Buck K, Nolte L et al. Op. Cit.