Many people put off thinking about future healthcare until facing serious illness. But waiting is risky. The best time to begin advance care planning is well before a medical crisis—when you’re healthy enough to think, talk, and choose. In this article, we’ll explore when to start, what life events signal it’s time, and how to ease into the process so your voice guides care when you can’t speak for yourself.
What is advance care planning (and why timing matters)
Advance care planning (ACP) is the process of reflecting on your values, discussing preferences with loved ones, and documenting those preferences in a formal or semi-formal way. It’s not a one-off “directive” only for end-of-life care—it’s part of responsible life planning. The Australian Department of Health describes ACP as useful even when you’re well: it helps loved ones and clinicians know your preferences ahead of crisis. (Health and Ageing Department)
Starting early ensures that:
- You can make thoughtful decisions (when you have capacity).
- Conversations happen in calm moments—not under stress.
- Your family, substitute decision-maker, and healthcare team are aligned.
- Your documents can evolve over time and be found when needed.
As the Advance Care Planning Getting Started Guide from ACPA bluntly states: the best time to begin is right now, regardless of your age or health. (Advance Care Planning Australia)
When to begin: key life stages & triggers
There’s no single “right” age, but several life stages and events strongly suggest it’s time to start:
1) Early adulthood / independence
Once you’re an adult (18+ in most jurisdictions) and managing your own medical decisions, it’s prudent to consider your values and appoint a decision-maker. Even if you are healthy, emergencies can happen unexpectedly. Advance care planning should be a living process, not reserved only for the elderly or chronically ill.
2) Diagnosis of chronic or life-limiting illness
When you—or someone you care for—is diagnosed with a condition likely to evolve (e.g., heart disease, kidney failure, cancer), that moment is often a cue. Formal guidance in Victoria notes that ACP can be initiated at key points in illness trajectory, such as after diagnosis or hospitalization. (Health Victoria)
3) Hospitalizations, medical setbacks or change in health status
A hospital stay, new complication, or sudden decline signals that your preferences may need revisiting. Many health services use these opportunities to prompt planning conversations. (Health Victoria)
4) Early cognitive changes or dementia risk
If you or a family member begin to face memory issues, mild cognitive impairment, Alzheimer’s disease, or another dementia risk factor, that’s a key time to start. Best practice suggests introducing ACP before capacity declines significantly. (NICE)
5) Life transitions or major events
Things like retirement, loss of a spouse, moving to assisted living, or a shift in finances often prompt reflection on what matters in life—including healthcare preferences.
6) As part of routine care for older adults
For older people managing multiple comorbid conditions, or approaching frailty, ACP should be a routine part of care reviews rather than a last-minute “end-of-life” plan. (Health Victoria)
In summary, these triggers provide natural opportunities to introduce the conversation—rather than waiting for a crisis
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Best practices for timing and pacing the conversation
It’s one thing to know when to start, and another to know how. Often, the timing and manner of launching the discussion can influence how comfortable and effective it is.
Begin gradually, not all at once
Victorian health guidance emphasises that advance care planning doesn’t need to be completed in a single session. Start the conversation, then revisit and build on it later. (Health Victoria)
Choose calm, unhurried moments
Avoid introducing the topic at overwhelming moments (e.g. in emergency rooms). Instead, pick times when both you and your intended decision-maker are relaxed and open to discussion.
Use natural cues
You might say “I read an article about advance care planning…” or reflect on a friend’s health scare. Let these prompts ease into significance.
Respect readiness and pacing
Some people need time to warm up to the idea. Don’t pressure; allow the conversation to unfold over weeks or months. As one caregiver guide notes, timing “can greatly influence how comfortable and effective the process feels.” (Care Learning)
Revisit at transitions
After diagnosis, hospitalization, or life changes, revisit preferences. Update them as your health, outlook, or priorities shift.
Document early, update often
Once discussions begin, capture core values or wishes—even before filling out full formal documents. Use a tool or vault (for example, Evaheld) so your evolving preferences are documented, backed up, and shareable with trusted people.
What to do at each stage
Here’s a simple roadmap matched to stages:
Stage | What you can start doing | Why it matters |
Early adulthood / healthy | Reflect on values, look up ACP resources, talk with friends/family | You build a foundation before crisis |
Upon health diagnosis | Ask “What would I want if this becomes worse?”; identify decision-maker | Ensures your care is aligned with your priorities |
After hospitalization | Revisit your values and possible scenarios | Treatments may change; new decisions may arise |
In early cognitive decline | Formalise your preferences while capacity remains | Prevents confusion later |
Routine reviews (age, chronic disease) | Bring up ACP on yearly check-ups | Normalises the topic and keeps your plan up to date |
As the Australian Government Department of Health describes: you don’t have to wait for a terminal diagnosis to start planning. (Health and Ageing Department)
Common concerns (and what to tell people)
“I’m too young / healthy for this.”
Even healthy people benefit from clarity about values and who would speak for them. In crisis, healthcare might be aggressive or misaligned without guidance.
“I don’t want to think about dying.”
It’s not all about death—ACP is about living by your values, even under uncertainty. Many find the conversations freeing, not morbid.
“My preferences might change.”
That’s expected. ACP is a living process. You can revisit decisions anytime—and update your documents. The latest version is what matters.
“It feels complicated or legal.”
Start small. Reflect on what matters first. You can formalise later with help from your GP or social worker. Tools and guides from Advance Care Planning Australia make it simpler. (Advance Care Planning Australia)
“My family will know what I want.”
Maybe—but emotions, stress, or disagreement can cloud decisions. A clear, documented plan protects your family from guessing, guilt, and conflict.
Why starting early leads to better outcomes
Research and policy backing confirm that early ACP:
- Reduces unwanted aggressive care and hospital stays in the last phase of life. (bjgp.org)
- Improves quality of end-of-life care by aligning treatments with goals. (bjgp.org)
- Decreases stress and anxiety for family members faced with decisions. (bjgp.org)
- Makes care teams more confident in knowing your wishes, reducing uncertainty. (safetyandquality.gov.au)
In short: the earlier you begin, the more time your plan has to mature, be shared, and be leveraged when it matters most.
Practical tips to get started today
- Download starter guides and prompts
Advance Care Planning Australia’s Getting Started Guide includes reflection questions and simple templates. (Advance Care Planning Australia) - Pick a trusted discussion partner
Choose someone who knows you well (spouse, child, sibling, friend) and is willing to listen. - Begin the conversation over time
Use open-ended questions like “What matters most to me if things change?” or “How would I want decisions made for me?” - Document core values first
Even a short “values statement” is a meaningful anchor. You can build from there. - Look into formalising later
When you feel ready, complete an advance care directive or equivalent in your state/territory. (Health and Ageing Department) - Store and share your preferences
Use structured, secure platforms (like Evaheld) to keep your documents, notes, and messages together—and share with the right people. - Review annually or after change
Revisit whenever your health, relationships, or circumstances shift.
What if someone resists or delays?
It’s fairly common—some resist due to fear, denial, cultural beliefs, or family dynamics. Approaches that can help:
- Normalise the idea: compare it to making a will or insuring your home—responsible planning.
- Start indirectly: talk about stories in the news, or what you’d prefer in a hypothetical scenario, to ease into discussion.
- Offer time and revisit: don’t push; allow space for reflection and come back later.
- Use facilitators or professionals: counselors, GPs, or trained ACP facilitators can ease the path.
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Extra Guidance
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