If a sudden illness or accident left you unable to express your wishes tomorrow, who would make decisions—and how would they know what you want? That’s the problem an Advance Care Directive (ACD) is designed to solve. In Australia, an ACD records your preferences for future healthcare and can also appoint someone to speak for you if you lose decision-making capacity. It’s not just for “later life” or people with serious illness. In fact, most experts recommend planning early so your values guide care long before a crisis.
This guide explains who needs an Advance Care Directive, why it matters across different life stages and situations, how it varies by state and territory, and the practical steps to make your directive discoverable—so the right people can find it when it counts.
What is an Advance Care Directive?
An Advance Care Directive is a formal record of your preferences for medical treatment and care if you can’t make decisions for yourself. It can include values statements, instructions about treatments you would or wouldn’t want, and the appointment of a substitute decision-maker (titles vary by jurisdiction). National resources from the Australian Commission on Safety and Quality in Health Care and Advance Care Planning Australia emphasise that a directive helps clinicians deliver person-centred, values-aligned care.
Importantly, terminology and forms differ by state/territory—for example, NSW Health recognises common-law directives alongside appointing an Enduring Guardian; Queensland uses an Advance Health Directive; South Australia and Victoria have statutory ACD frameworks; and Western Australia uses an Advance Health Directive.
So… who needs an Advance Care Directive?
Short answer: almost every adult in Australia benefits from having one. Here are the groups for whom it’s especially important.
1) Every adult aged 18+
Emergencies can happen at any age. If you’re legally an adult, an ACD makes your preferences clear and designates who can speak for you if you cannot. Advance Care Planning Australia encourages all adults to think ahead and document their values, while My Aged Care emphasises the benefits for individuals and families—including reduced confusion and conflict in stressful moments.
2) People living with chronic or complex conditions
If you have heart disease, diabetes, chronic respiratory illness, kidney failure, cancer or other ongoing conditions, treatment decisions can become complex. Documenting your preferences early helps care teams align care with your goals. State guidance (e.g., Victoria) frames ACDs as part of routine care planning for people with chronic disease.
3) Older adults and those experiencing frailty
Ageing can bring multiple conditions and frailty, increasing the chance of hospitalisations. Having an ACD—and reviewing it regularly—ensures your wishes are documented before any acute event. My Aged Care provides consumer-friendly information for older Australians and their families.
4) People at increased risk of losing capacity
Early memory changes, mild cognitive impairment, dementia, serious mental illness, or neurological conditions are strong reasons to formalise wishes while you still have capacity. National resources encourage early conversations and documentation so decision-makers and clinicians have clear guidance later (see Advance Care Planning Australia and Palliative Care Australia).
5) People in residential aged care or receiving community care
If you’re moving into residential aged care—or receiving structured community care—it’s an ideal time to complete an ACD and lodge copies with providers. My Aged Care explains how planning supports person-centred care and helps staff respond quickly and appropriately.
6) People facing surgery or high-risk treatments
Before major elective surgery or treatments with significant risks, an ACD ensures your preferences are known if complications affect capacity. Discuss scenarios with your surgeon or GP and record what matters to you; national guidance from the Australian Commission on Safety and Quality in Health Care encourages integrating directives into care pathways.
7) Carers and families who want clarity
Carers often shoulder tough decisions. Completing your own ACD—or supporting a loved one to complete theirs—can reduce guilt, conflict, and guesswork. The Carer Gateway provides practical information to help carers start and sustain these conversations.
8) People with strong cultural, spiritual or personal values to honour
Your directive can capture cultural or spiritual needs, such as preferences around family involvement, Country and kinship, or end-of-life rituals. Palliative Care Australia encourages people to include these in their planning so care is respectful and aligned with identity and community.
Why it’s useful even when you’re healthy
Many people assume “I don’t need this yet.” But planning before illness has clear advantages:
- Autonomy: Your values—not the urgency of the moment—guide care.
- Less stress for loved ones: Families are spared from guessing.
- Better, faster clinical decisions: Health services increasingly rely on accessible ACDs to tailor care; national standards highlight person-centred decision-making (see the Australian Commission).
- You can revise anytime: An ACD is a living document—review and update after life changes.
If you prefer to build towards formality, you can start with conversations and a values-based advance care plan, then complete your formal directive when ready (see Advance Care Planning Australia for step-by-step support).
How directives differ across states and territories
Australia’s overarching principles are consistent, but specifics vary:
- New South Wales: Common-law Advance Care Directive and appointment of an Enduring Guardian.
- Queensland: Advance Health Directive can include treatment instructions and appoint an attorney for health matters.
- South Australia: Statutory Advance Care Directive (values, instructions, and substitute decision-maker in one).
- Victoria: Advance Care Directive under the Medical Treatment Planning and Decisions Act (instructional and values directives, plus appointment of a medical treatment decision-maker).
- Western Australia: Advance Health Directive with updated forms and guidance.
- ACT, NT, Tasmania: Frameworks are broadly similar—use Advance Care Planning Australia’s state pages for the exact forms and witnessing requirements.
Tip: Always use the correct, current form for your jurisdiction and follow witnessing instructions carefully. Your GP or practice nurse can help ensure the wording is clinically interpretable.
Who should you appoint as your substitute decision-maker?
If you lose capacity, a legally appointed decision-maker speaks for you. Titles vary (e.g., Enduring Guardian, Medical Treatment Decision-Maker, Attorney for health matters), but good principles are the same:
- Choose someone who knows you well and can stay calm under pressure.
- Make sure they understand your values and priorities.
- Confirm they’re willing to advocate for your wishes—even if others disagree.
- Name a backup in case your first choice is unavailable.
Your state or territory pages via Advance Care Planning Australia explain how to appoint and legally authorise this person.
Making your directive discoverable (not just “done”)
A common pitfall is finishing paperwork but not storing or sharing it where people can actually find it. Use a three-layer strategy:
- Share with people: Give copies to your decision-maker, family, and GP. If you live in residential aged care, ask the service to store it with your care plan (see My Aged Care).
- Upload to My Health Record: The Australian Digital Health Agency provides a dedicated section for advance care planning documents so hospitals can see them in emergencies.
- Keep a trusted digital backup: A secure personal vault like Evaheld lets you centralise your directive, guardianship papers, and messages to family, keep them updated, and share with the right people. This complements clinical storage by making your latest version easy to access and manage.
Myths and misunderstandings—quick answers
“An ACD is only for the very ill.”
Not true. It’s useful for every adult, especially because emergencies are unpredictable. Early planning reduces stress and guesswork.
“My partner can just decide.”
Without formal appointment, there may be ambiguity or disputes. Use your jurisdiction’s process to legally appoint a decision-maker (e.g., NSW Enduring Guardian).
“It’s complicated and legalistic.”
It can be straightforward with clear guidance from Advance Care Planning Australia and your state health department. Your GP can help translate your values into clinically useful wording.
“I might change my mind.”
Great—ACDs are living documents. Review after major life or health changes and update everywhere your directive is stored—including My Health Record and your vault (e.g., Evaheld).
Special considerations
- Culturally and linguistically diverse communities: Ask for interpreters, translated materials, and culturally respectful care. Palliative Care Australia and Advance Care Planning Australia host inclusive resources.
- Aboriginal and Torres Strait Islander peoples: Include Country, kinship, Sorry Business, and cultural needs in your directive and care preferences; share these with your care team to ensure respect and alignment.
- LGBTQ+ communities: Use your directive to specify who should be consulted and what supports you want, especially if family dynamics are complex.
- Carers: The Carer Gateway provides tools to help you support a loved one’s planning and to understand your role if you’re the appointed decision-maker.
Step-by-step: how to put your ACD in place
- Reflect and talk: Use conversation guides from Advance Care Planning Australia to think about values (comfort vs longevity, place of care, independence, spiritual needs).
- Choose your decision-maker(s): Pick someone who knows you and can advocate confidently; consider a backup.
- Use the right form: Find and complete your jurisdiction’s current directive (e.g., NSW Health, Queensland AHD, SA ACD, Victoria ACD, WA AHD, or via state/territory contacts). Follow witnessing rules exactly.
- Ask your GP to review: Clinicians can help ensure language is clear and your directive is saved into your medical record. The Australian Commission promotes embedding ACDs in care.
- Store, upload, and share: Upload to My Health Record, share copies with key people, and keep a secure digital copy in Evaheld.
- Review and refresh: Update after any big life changes—new diagnoses, hospitalisations, changes in relationships or goals. Replace older versions wherever they live.
Future-Proof Your Family’s Story: Why an Evaheld Legacy Vault Is the One Account You’ll Never Regret Opening
Imagine your great-grandchildren hearing your laugh, reading your life advice and seeing your Advance Care Directive in the same secure space—long after today’s social apps have vanished. That’s exactly what the Evaheld Legacy Vault delivers: a single, lifetime-guaranteed home for everything that matters, from milestone videos to legally valid health wishes. Below you’ll discover what the Vault does, why it’s different and how you can lock in a free account in minutes.
1. One Vault, Every Memory
Create rich, first-person history with in-browser video, audio, photos, written reflections, legacy letters and even ethical wills. Your stories live alongside recipes, playlists and private notes—ready to inspire loved ones for generations.
2. Dedicated “Rooms” for the People Who Matter
Open individual or shared rooms so each grandchild, sibling or friend has their own space to swap memories and request new ones. Two-way messaging keeps conversations vivid and private. Or invite entire families to a “Family Room” to ensure that your family’s history and legacy is all in one place - secure forever for future generations!
3. Advance Care Planning That Actually Gets Finished
The Vault walks you through Australia’s most intuitive Digital Advance Care Directive. Once signed, it sits beside a full Health & Care Preferences section that loved ones, carers and clinicians can access instantly—no more frantic document hunts.
4. Emergency Access That Saves Time and Protects Your Wishes
Print your QR Emergency Card; first responders scan it and see the latest directives in six seconds. Tests show on-scene decisions become faster and better aligned with personal wishes.
Watch why our work is so important to us.
5. Secure Home for Every Important File
Create and upload wills, powers of attorney, insurance details, super and bank info with bank-grade encryption. Granular permissions mean only the right people ever see the right files.
6. Key Contacts Always Up to Date
Keep one live list of attorneys, guardians, executors and advisors. Change a phone number once and it syncs everywhere—so your family never scrambles for contacts in a crisis.
How It Works
- Launch Your Vault – Start free in minutes through the simple free Evaheld Legacy Vault..
- Invite & Open Rooms – Add loved ones and set up dedicated spaces to trade content requests.
- Create, Share & Relax – Let the built-in AI assistant tag, file and schedule everything while you go live life.
Why Thousands Are Preserving Their Legacy With Evaheld
- A Priceless Heirloom – Your Vault becomes a digital time capsule future generations will treasure.
- Ongoing Connection – Schedule birthday videos, graduation letters and milestone messages years ahead.
- Cross-Generational Peace of Mind – Families see care wishes and personal stories, reducing conflict and anxiety.
- Always Free for Early Users – Launch now and secure lifetime storage at zero cost on our freemium plan.
Dive Deeper Into Legacy & Care Planning
- Watch our Founder's Story to learn why we’re so passionate about Legacy Preservation and Advance Care Planning
- Follow our step-by-step guide to crafting a powerful legacy statement.
- Sign Up and Download a free Evaheld Legacy Letter Kit!
- Discover easy techniques for turning life lessons into messages.
- Get tips from our “How to Preserve Your Story” tutorial.
- See who we help in Evaheld Community.
- Sign up for free and discover the Evaheld Legacy Vault: What’s Inside a Vault.
- Hear real users explain why they signed up: Legacy That Loves Back.
- Read the full list of Vault benefits.
Extra Guidance
For guidance tailored to your needs, explore trusted dementia help sites, resources on family legacy preservation, online wills and estate planning platforms, and dedicated advance care directive resources. You’ll also find expert guidance and secure Evaheld Legacy Vault services, along with valuable information for nurses supporting end-of-life planning and values-based advance care planning. Evaheld is here to ensure your future planning is secure, meaningful, and deeply personal — with family legacy preservation resources designed to support your advance care planning, and those closest to you: families, carers, and communities.
Ready to Future-Proof Your Voice?
Opening an Evaheld Legacy Vault costs nothing, secures everything and takes less time than brewing a coffee. Your family’s story deserves a permanent, private home—claim it today and start creating memories that will matter forever.
Start your Evaheld Legacy Vault for FREE and secure your story and family legacy!
Evaheld’s “Connection is all we have” Hardship Policy
At Evaheld we believe that everyone’s story and legacy is worth sharing, so if you or someone you know needs some hardship assistance, please reach out and let us know, and someone from our team will ensure that money will not prevent anyone from securing their story, connections and legacy for loved ones and future generations. Because at Evaheld we believe that “Connection is all we have,” and that every single story and legacy is worth preserving!
Share this post