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Almost a third of Advanced Care Directives (ACDs) audited in Australian residential aged care facilities were found to be invalid, according to a nation-wide study.

The research, led by Advance Care Planning Australia (ACPA), revealed 30% of ACDs in residential aged care had been completed by someone else (usually family members) on behalf of a non-competent person. Unsettlingly, 68% of those documents included instructions for withholding life-sustaining treatment such as tube feeding or intravenous antibiotics.

An ACD is a legal document outlining a person’s preferences and instructions for their future healthcare. The document comes into effect when a person is no longer capable of making their own medical decisions. However, ACDs are only legal when completed and signed by a person with decision-making capacity.

This oversight potentially leaves aged care residents at risk of being denied access to medical treatment they would have wanted, or given treatment they would have preferred to avoid. The ambiguity also creates risk and confusion for aged care staff, families and healthcare providers.

“These findings underscore a broader societal issue that advance care planning needs to start earlier, before people enter care and ideally when they’re well enough to make their own decisions. For many aged care residents entering care, it’s too late to start advance care planning. We urge Australians to plan well, plan early and involve those closest to you,” said Program Director of ACPA Linda Nolte.