Study examines advance care directive uptake

Researchers are collating data from a range of healthcare organisations to determine whether older Australians are receiving suitable advance care planning that aligns with the medical care they want and their personal values and preferences.


General practice clinics, aged care facilities and hospitals are among organisations taking part in the ground-breaking study about Advance Care Directives (ACDs) in healthcare services.

Led by Advance Care Planning Australia (ACPA), the National Advance Care Directive Prevalence Study 2018 involves auditing the health records of people aged 65 and over to uncover the prevalence of ACDs and other advance care planning documentation.

The result of a successful pilot study undertaken in 2017, the latest full-scale research aims to create a national dataset of Advanced Care Directive prevalence to evaluate how well an individual’s care plan aligns with their personal preferences, as outlined in their ACD.

Advance care planning allows people to make choices on their future healthcare in case the time comes when they are no longer able to communicate their decisions.

Figures shows almost 50% of people will not be able to make their end-of-life medical decisions and that less than 15% of Australians have documented their preferences in an Advanced Care Directive.

The study has received federal government funding to run each year until at least 2020 and aims to help shape state and national advance care planning policy and track areas for improvement.

ACPA Medical Director Karen Detering said ACDs were beneficial in guiding treatment decisions but when unable to be easily accessed in people’s records requested care was less likely to be carried out.

“Currently, there is a lack of data on how prevalent Advance Care Directives are for older Australians in health and residential aged care services,” Ms Detering said.

“The available evidence suggests prevalence is low but we need to better understand the situation if we’re serious about supporting more Australians to receive the end-of-life care that they want.”

In June, ACPA reported a 462% surge in calls to their advisory service, which helps people navigate the complexities of advance care planning, including offering specialist advice and assistance with forms and documentation.

The free nationwide advisory service has been running since 2014, supporting individuals, families and healthcare professionals with specialised advanced care planning information, research and advice.

The recent surge in call volumes is being attributed to a range of factors, including greater awareness through the inaugural National Advance Care Planning Week, held in April this year, and several legislative changes governing advance care planning.

Ms Detering said the National Advance Care Directive Prevalence Study 2018 offered a great opportunity to investigate how well directives are being implemented and support quality improvement.

All staff members from participating organisations will receive a training package and ongoing support to upskill their knowledge of advance care planning.

Further, once data is collected, participants will receive a customised report showing their results benchmarked against other participating organisations.

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