More than two-thirds of older Australians are side-stepping the opportunity to control their end-of-life care, with men less likely to plan than women.
New research has found 70 per cent of Australians aged 65 and do not have any form of advance care planning document in place and of the 30 per cent that do, the majority of them are either incomplete, invalid or not legally binding.
The study was led by Advance Care Planning Australia (ACPA) - a government-funded program aimed at giving older Australians choice and control over their future medical treatment decisions and end-of-life care.
According to ACPA, around a third of people will be unable to make their own end-of-life decisions. An advanced care plan (ACP) offers people the opportunity to clarify their medical treatment preferences in advance, preparing themselves and loved ones for a time when they can no longer communicate.
The ACPA study, which audited the health records of more than 4000 older people in hospitals, GP clinics and aged care facilities across Australia, found that among the 30 per cent of older Australians with ACP documents, only 14 per cent of these were legally-binding advance care directives (ACDs).
These are considered to be the gold standard of ACP documents, which can only be completed by a person with decision-making capacity.
The majority of ACP documents that were found among older Australians were advance care plans, where preferences are reported by either family or healthcare professionals. These documents can be used to guide care but are not legally binding.
The study also found that women were more likely to have an ACD.
ACPA program director, Linda Nolte, said while an ACP is not mandatory, she was concerned for older people who expect to remain in control of their medical decisions as they age.
"If choice and control is important to you, advance care planning should be on your radar," she said.
"An important part of healthy ageing is making informed healthcare choices.
"We urge people to take active steps to control their future care and create a legally-binding ACD, while they still have decision-making capacity.
"It means you're more likely to get the care you want and avoid treatment you don't want. It also relieves loved ones of the burden of making life-and-death decisions by guesswork."
She said it is also important that your ACD is coherent and properly dated, signed and witnessed.
"It may be the difference between whether your doctor follows your directive or not," she added.
Directive or plan: what's the difference?
Advance care directives and advance care plans: these two terms are used regularly when talking about advance care planning, so what's the difference.
Advance care directives
An advance care directive is sometimes known as a living will.
It's something you create for yourself and involves documenting your preferences for future care. It can include your values, life goals and preferred outcomes, and directions about care and treatments. You can also formally appoint a substitute decision-maker in an advance care directive.
Theprocess of creating an advance care directive and the names of the required documents varies between states and territories.
Advance care directives are legally binding and the preferences for health care that you document must be followed.
Advance care plans
An advance care plan is created by someone else on behalf of a person with diminished or no capacity to make decisions for themselves.
An advance care plan can include an individual's beliefs, values and preferences in relation to future care decisions. They are often helpful in providing information for substitute decision-makers and health practitioners and may guide care decisions but are not necessarily legally binding.
Some states and territories provide forms to help document an advance care plan for a non-competent person.
Advance Care Planning Australia offers free information and advice on 1300 208 582.