Planning for Future Healthcare: The Importance of an Advance Health Directive
Most of us don't spend much time thinking about what would happen if we couldn't make our own healthcare decisions.
An accident, serious illness, or other health event can change that very quickly.
An Advance Health Directive, or AHD, gives you the opportunity to make certain decisions about your future healthcare while you have capacity.
It can tell your healthcare providers what treatment you want, or don't want, in specified circumstances if you later can't make or communicate those decisions yourself.
It can also allow you to appoint an attorney for health matters.
An AHD can be an important part of your estate plan, particularly when considered alongside your Enduring Power of Attorney.
What is an Advance Health Directive?
An Advance Health Directive is a legal document used in Queensland to give directions about your future healthcare and medical treatment.
Your directions can cover matters such as life-sustaining treatment, including CPR and assisted ventilation, as well as other healthcare and treatment decisions.
An AHD is used when you can't make or communicate the relevant healthcare decisions yourself. You can also use an AHD to appoint an attorney for health matters.
This means an AHD can help you plan for two different situations:
decisions you want to make yourself in advance through directions in the AHD; and
decisions you want a person you trust to make for you if the relevant issue isn't covered by your directions.
Is an Advance Health Directive legally binding?
Yes, an AHD is a legally binding document. That is an important distinction between an AHD and other documents that record your healthcare wishes.
An AHD can contain legally binding directions about future healthcare. There are also circumstances where a healthcare provider may not be required to follow an AHD direction.
For example, a health provider does not have to follow a direction that is inconsistent with good medical practice, is uncertain, or is no longer appropriate because circumstances have changed.
This is one reason it is worth discussing your proposed directions with your doctor.
Why have an Advance Health Directive?
You can make important decisions while you have capacity
An AHD gives you an opportunity to think about your healthcare before you're faced with a situation where you can't communicate your wishes.
You can consider what matters to you, what quality of life means to you, and how you feel about different types of medical treatment.
You don't have to wait until you're elderly or seriously ill. Unexpected accidents and illnesses can happen at any age.
Your family doesn't have to guess what you would have wanted
When someone loses capacity, their family can be left wondering what decisions they should make.
An AHD can provide clear directions about the healthcare decisions you've already considered. It can also provide your family and healthcare providers with a better understanding of what matters to you.
That can be particularly valuable during an already difficult time.
Your healthcare providers have clearer information
An AHD gives healthcare providers a formal document to consider when you cannot make or communicate the relevant decisions yourself.
It can provide directions about treatments and care in the circumstances covered by the document.
Do I need an AHD if I have an Enduring Power of Attorney?
An AHD and an Enduring Power of Attorney are different documents.
An EPA allows you to appoint someone to make personal, including health, and/or financial decisions for you when the relevant authority applies.
An AHD allows you to make certain healthcare decisions in advance. It can also appoint an attorney for health matters.
The documents can work together.
For example, you may want to make your own directions about particular medical treatments through an AHD, while also appointing someone you trust to make other health decisions on your behalf.
Your estate planning lawyer can help you consider how the documents should work together as part of your broader plan.
Who should consider making an AHD?
Anyone over 18 with capacity to make the document can consider making an Advance Health Directive.
An AHD can be particularly worth considering if:
you have a serious or chronic health condition;
you're preparing for significant surgery;
you have concerns about particular medical treatments;
you have strong views about future healthcare;
you want to make decisions about life-sustaining treatment in advance; or
you simply want to have a plan in place in case you become unable to make healthcare decisions.
You don't need to be sick to make one and you ought to consider an AHD before an urgent health situation arises.
How do you make an Advance Health Directive?
1. Think about what matters to you
Before completing the document, think about your values, your views about healthcare, and the types of treatment you may or may not want in different circumstances.
The AHD form covers a range of situations, so it's worth taking the time to understand the questions and options.
2. Talk to your doctor
A doctor must complete the relevant certificate confirming that you have the capacity to make the AHD and that they have discussed the contents of the document with you. They can help you understand the medical treatments covered by the document.
3. Complete and sign the AHD
You must sign the AHD in the presence of an eligible witness. An eligible witness can be a:
Justice of the Peace;
Commissioner for Declarations;
lawyer; or
notary public.
If you appoint an attorney for health matters through the AHD, the attorney will also need to accept the appointment before they can act in that role.
4. Make sure the right people know about it
Once your AHD is completed, don't put it somewhere nobody will find it.
Keep the original safely and make sure the people who may need to know about it, including your attorney, family, GP, and relevant healthcare providers, know that it exists and where to find it.
Does an AHD expire?
An AHD doesn't simply expire after a set period.
You can revoke your AHD while you have capacity, and you can make a later AHD if your wishes change. It's still a good idea to review your AHD when your circumstances change.
For example, you might experience a significant change in your health, develop new views about medical treatment, or simply decide that the directions you previously made no longer reflect what you want. Medical treatment also changes over time.
If you have an AHD, it's worth making sure you understand what your existing directions say and whether they still reflect your wishes.
Where does an AHD fit into your estate plan?
Your estate plan isn't only about what happens after you die. It should also consider what happens if you are alive but unable to make important decisions for yourself.
Your Will deals with your estate after your death. Your Enduring Power of Attorney allows you to appoint someone to make relevant personal and/or financial decisions for you. Your Advance Health Directive allows you to make certain healthcare directions in advance and can also appoint an attorney for health matters.
Together, these documents can form an important part of your lifetime and estate planning. The right combination will depend on your circumstances and the decisions you want to make in advance.
Planning ahead gives you a voice
Thinking about future healthcare isn't always easy. You may not know exactly what you would want in every possible situation, and you don't need to.
An Advance Health Directive gives you an opportunity to think about the healthcare decisions that matter to you, record directions where appropriate, and appoint someone you trust to make health decisions where you want them to have that role.
It's one part of a broader estate plan designed to protect you during your lifetime and help your loved ones understand what you want. If you're considering an Advance Health Directive, we can help you understand how it fits with your Enduring Power of Attorney and the rest of your estate plan.