1. Substitute decision-maker

2. Advance Care Planning Australia is an initiative of Austin Health and is supported by funding from the Australian Government.

3. What it means to be a substitute decision-maker
Advanced illness or serious injury can sometimes mean that people cannot make their own decisions about health care. This can happen to people of all ages, health and especially towards end-of-life.
Advance care planning promotes care that is consistent with a person’s goals, values, beliefs and preferences
Writing an advance care directive lets a person say what they would want, if they ever became unable to communicate for themselves.
It’s invaluable because making health care decisions for others can be difficult and this provides clear direction and guidance.
When a person prepares their advance care plan, they may invite someone to be their substitute decision-maker to ensure their voice is heard.
In the case where the person loses the ability to make their own healthcare decisions, the substitute decision-maker can make treatment decisions on their behalf.
Would you be prepared to be a substitute decision-maker if you had clear instructions?

4. Who can be a substitute decision-maker?
If someone asks you to be their substitute decision-maker ensure you are:
available (ideally live in the same city or region)
over the age of 18
prepared to advocate clearly and confidently on your behalf when talking to your doctors, other health professionals and family members
have discussed with the person their values, beliefs and preferences
preferably have a copy of their advance care directive

5. Advance care planning is a process
Be Open
Think about what it means to be a substitute decision-maker and ensure you are eligible before you agree.
Talk about values, beliefs and preferences with the person who you may need to make decisions for and encourage them to talk through their preferences with family, friends and health professionals involved with their care
Be Ready
Talk with the person about their values, beliefs, and life goals. Make sure you understand and respect their approach to health care and end-of-life decisions.
If they have beliefs that you are opposed to, be honest with them. Remember that you may be called upon to advocate for them. If your beliefs are too different, it may be better for them to choose someone else.
Talk about any potential issues that may arise with family members or partners who have very different views. How will you cope with any disagreement that could arise? Have they been made aware of the person’s preferences? Do they know you are the substitute decision-maker?
Be Heard
Encourage the person to write an advance care directive. A GP or health professionals will be able to assist them.
Ask for a copy of the advance care directive and keep it safe. Familiarise yourself with the person’s preferences and ask them to explain anything that isn’t clear.
Encourage them to review their Advance Care Plan every year or if there is a change in their health or personal situation.
If there did come a time when they couldn’t communicate, an advance care directive makes things easier and ensures their health care preferences can still be heard and respected.

6. Find out more
Visit our website at advancecareplanning.org.au for a range of resources:
Fact sheets
Forms
Videos
Case Studies
Learning modules
Research reports
Contact our Advisory Service on from 9am - 5pm (AEST) Monday to Friday.
Please note that different states and territories in Australia have different laws on advance care planning, therefore it is important to understand the law in your own state/territory.
Visit the website where you will find a full suite of resources or contact the Advisory Service