Department of Health

Documentation guide

  • 02 December 2015
  • Narrator:

    here may be variations within advance care planning forms in different regions however; these self-contained documents consist of information and questions relating to patient choices. The introductory section of the document contains guidelines and an overview explanation of the advance care planning process, consisting of voluntary and mandatory components including the role of a medical enduring power of attorney and how to appoint one; what the refusal of treatment certificate is, how to complete it and what this means for future health choices; and how patients can record their personnel wishes for future medical care within the Statement of Choices document.

    The forms also include information about updating and adapting advance care plans depending on changing circumstances and situations, and guidance regarding what individual’s plans can consist of, as well as advice to complete the process, broken down into simple steps aimed towards assisting both facilitators and participants. Finally, the introductory section offers contact details for those wishing to seek further information or assistance.

    The section relating to Statement of Choices is where future health care wishes can be recorded. These forms give the opportunity for people to document their personal information and to clarify that they understand what this form is for and how it will be used to help doctors and other decision makers to respect their wishes. This page also includes questions relating to specific procedures and interventions that patients can indicate that they would or would not want, as well as the opportunity to clearly express what they feel are reasonable outcomes. They also have the option to delegate these decisions to their medical enduring power of attorney.

    The final page of this form consists of more detailed questions relating to individual value statements regarding quality of life as well as situations that they would find unacceptable. There is also the option to include further information to assist in decision making about future health care, as well as more personal and specific requests that they would want to be known and considered if nearing death. When filled out, this section provides a good framework for others to understand the participant’s ethos and philosophies relating to their life and death. The completion of the final section of this form, through signing and counter signing, dating and witnessing formalises this documentation.

    Completed contact information is of course an important element to a thorough advance care plan, identifying not only the contact details of the participant but also their ultimate agent and information regarding who has been given copies of their plans.

    The additional enduring power of attorney forms record information regarding who has been appointed to make decisions about medical treatment on a patient’s behalf.

Information Guide for clients on Advance Care Planning Process

Reviewed 02 December 2015


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