Does your patient have Advance Care Planning documentation? 

It doesn’t matter if a patient is in acute, sub-acute, outpatients, community or residential care – at any point of care, employees need to be looking to see if they have any Advance Care Planning (ACP) documentation. These may include the following: Advance Care Directive, Appointment of Medical Treatment Decision Maker, or Appointment of Support Person.  

Key actions: 

  • Ask the patient or a family member if they have any ACP documents 
  • Take a copy of the document/s and send to ACP Service for lodging on SMR and creation of alert  
  • Check ACP alerts in EMR 
  • Check SMR (legal tab) for copy of document/s 


Advance Care Planning is about planning ahead for a patient or consumer’s future healthcare, in case they are ever too sick to speak for themselves. A simple way to understand and do advance care planning is ACP in 3 steps. 

A: Appoint another 

They can sign a legal form making it clear who they want to make medical decisions for them if they are too sick to do it themselves. This is a ‘Medical Treatment Decision Maker’. 

C: Chat & Communicate 

Encourage them to talk to family, friends, and doctors about their values, beliefs and health care preferences. Tell them about what is important. Also, talk to doctors or other health professionals to find out more about what might be ahead. 

P: Put it on Paper

If there is something they feel strongly about, they can write it down in an Advance Care Plan / Directive or in a letter describing their health care values and preferences for future medical treatments, including what type of medical treatment they would agree to, and what they would not want. 

It is important we all consider Advance Care Planning, however, it is particularly important if a patient or consumer is: 

  • Over 75 years of age
  • Has chronic health issues
  • Has health conditions that may affect their ability to make decisions in the future
  • Has firm preferences about future medical treatment
  • Has no-one, or no-one suitable, that they could appoint as a Medical Treatment Decision Maker
  • Has preferences for their health care that are different from what they think their family would want for them.

Need assistance? 

Monash Health Advance Care Planning Program offers a free service to assist patients or consumers in discussion and document preparation. 

Contact 9594 3475 or email 

Approved by Jenny Pace 

Previous Next
Test Caption
Test Description goes like this
This website is for Monash Health employees. Please be mindful before sharing links.Learn more