Advance care directive is the usual Australian term for a document recording a person’s wishes about future healthcare if they can no longer make or communicate decisions. You may hear someone call it an “advanced care directive,” but advance is the word used by Australian health services. The document grows out of advance care planning: conversations about values, treatments and the people who should speak for you. It becomes especially useful when a sudden illness leaves no time for those conversations.
What does an advance care directive actually do?
It can record what matters to the person and, depending on the state or territory, give legally relevant instructions about healthcare they would accept or refuse. Some people also formally appoint a substitute decision-maker. That person can help clinicians make decisions if the patient cannot, but their role and title differ around Australia. A directive is more than a general statement such as “I want to be comfortable”: it may include specific preferences about treatments, care settings and who should be contacted.
There is no single Australian form. Names, signing and witnessing rules, and legal effect vary by jurisdiction. A document made in one state may need careful consideration when used in another. For a person writing one, the safest starting point is the form and guidance for their own state or territory, plus a discussion with their healthcare team. A first aider at an emergency scene should not try to decide whether a document meets every legal requirement.
How is it different from an advance care plan?
Advance care planning is the process of thinking, talking and recording preferences. An advance care plan may be a written record of those conversations, sometimes prepared when the person cannot complete a formal directive. An advance care directive is a document made by the person when they have decision-making capacity and can carry legal force if its requirements are met. The distinction matters to clinicians; at the scene, both kinds of document may contain useful information that should be passed on promptly.
A resuscitation plan is another related document. It gives clinical instructions for particular circumstances and may be important to ambulance and healthcare teams. It is not simply a different name for an advance care directive. A family member’s memory of a conversation is valuable context, but it is not a substitute for finding the actual document or making its details available to responders.
What should a first aider do if someone mentions a directive?
First, deal with the immediate scene: check safety, responsiveness and breathing, and call Triple Zero (000) for a time-critical emergency. Tell the operator early that an advance care directive or resuscitation plan may exist. Say where the document is, who has a copy and whether there is a named substitute decision-maker. Follow the operator’s instructions and any applicable training or workplace protocol while ambulance officers are on the way. Do not delay an emergency call while searching through a folder or phone.
For example, a neighbour collapses at home and a relative says, “There is a directive in the blue folder.” One person can call 000 and describe the person’s condition while another retrieves the folder. The first aider gives the document to arriving paramedics and reports what they have observed. They do not make their own legal ruling about whether a clause applies to the collapse. That judgement depends on the document, the situation and the professionals responsible for care.
Where should the document be kept?
A document nobody can find may not help when it matters. The person should tell their substitute decision-maker, family and healthcare team where the current version is held. Healthdirect says advance care planning documents can be uploaded to My Health Record. A paper copy in an agreed place can still be useful for people assisting at home, especially if power, phone access or account sign-in is a problem. At a workplace, aged-care service or supported living setting, staff should know the local process for locating and handing over documents.
Review the directive after a major change in health, treatment or personal circumstances, and replace old copies when it is updated. A document does not normally need to be recreated every year merely because time has passed, though some jurisdictions allow an expiry date. The important questions are whether the person still agrees with it, whether the correct version is accessible and whether those who may need it know it exists.
What belongs in the handover?
Tell responders the person’s condition now, when it changed, what first aid has already been given, and the exact words used by the person or family about a directive. Show the document, rather than summarising it from memory. If a substitute decision-maker is present or reachable, provide their name and contact route. Distinguish what you witnessed from what someone else told you. This lets the clinical team assess the situation and the document together.
The practical meaning of advance care directive is therefore twofold: it is a record of the person’s future healthcare choices, and it is information that must be available to the right people at the right time. For first aid, the safe task is to recognise it, report it clearly and keep immediate care moving under the emergency operator’s guidance.
Sources checked
- Healthdirect: Advance care planning
- Advance Care Planning Australia: Record your choices
- Australian Government: National framework for advance care planning documents
Sources checked 10 October 2026. This entry explains terminology and first-aid handover; it is not legal or individual medical advice. In an Australian medical emergency, call 000.
