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Buried Under Paperwork – and struggling

Author: Christine Bowman
19 August 2015
  • Christine Bowman runs advance care planning sessions for the Health Care Consumers’ Association under the banner of A Conversation for Everyone

And, looking further, trussed upin red tape

Have you ever had the feeling of being overwhelmed by choice and confused over what you want? I certainly have, regularly.

Picture this; I’m walking through the supermarket and the internal monologue goes something like this: Cereal, we need cereal…  Holy moly! How many different types of cereal are there?  Every one of them says they are better than the next, and all of them are better than sliced bread. I read the labels … confusion. Surely there is something that doesn’t change all the time?

Benjamin Franklin thought death and taxes were the only certainty, but I’m sure I just heard that some people aren’t paying any tax!

That leaves death, the only 100 per cent certainty – regardless of what cereal we eat, what bread we buy and whether we pay our tax or not. It’s a bit of a bummer really, but facts are facts. I have heard we can have a say in how we shuffle off this mortal coil helped by something called Advance Care Planning (ACP) – at least that’s what it’s called in the ACT.  I think a little research is in order. Google here I come!

I found many terms and documents used in different parts of Australia, all of which cover some aspect of planning our future healthcare and which can help us and our loved ones make the choices we need in our dotage.

Ok I won’t panic. We’re not buying cereal; this is important, this is serious. We all die, it’s the one constant.

The exhausting process – were I to embark on it – of matching the terminology in the following table to the states and territories from which each originates, prompts the suggestion that surely we can match it with consistency in terms – in documentation – somewhere? We need this if we are to achieve the national potential of advance care planning.

Advance Care Plan

Enduring Power of Attorney

Power of Attorney

Statement of Choices

Living Will

Health Direction

Enduring Guardian


Advance Care Directive

Advance Consent Decisions 

Advance Care Statements

Substitute Decision Maker(s)

Refusal of Treatment Certificate

Advance Personal Plan

Advance Health Directive

I’ll be honest with you, my enthusiasm is waning. I fully understand that at this point going to the movies is looking attractive.

However, it is my job as Co-ordinator of the Health Care Consumers’ Association Advance Health Care Planning Program, A Conversation for Everyone, to make sense of this on behalf of those I speak with. I appreciate how daunting it can be – particularly for anyone who moves interstate or lives in border towns.

I also understand that each state or territory honours the documentation of other jurisdictions, but can we be sure? This is bureaucracy after all.

Everything I know and have experienced tells me it is better for all concerned – family, friends, partners and medical staff – if our wishes about end of life care are voiced, understood and, if possible, documented.

I believe that if we’re going to ask people to be courageous – and it does take courage to contemplate and speak with our family about our own demise – it is not too much to ask for simple, supportive and standardised procedures and terminology.

I know it’s not easy to get consensus between states and territories, but if we want to engage people on this difficult topic we need to reduce the barriers – not erect more administrative ones.

We need to respect the people thinking about this challenging area and those who choose, or to whom the task falls, to fill out the forms.

That’s not to forget the medical staff and family members who are going to be making decisions based on the wishes or orders contained therein. Quite frankly, I should not be relating this subject to the confusion of a supermarket shelf. It is too important for that.

Although health care is a matter for individual states and territories we need to work together and make the documents required for advance health care planning as consistent as the reason for which we are filling them out.

Would you like to learn more?  It can be as simple as ABC.

A. You can attend a community information session

B. You can arrange for a trained facilitator to provide information to your group

C. You can arrange for a trained facilitator to help you complete an Advance Care Plan.

If you are interested in any of these, please contact me: Christine Bowman, Coordinator of A Conversation for Everyone, Advance Care Planning on 02 6230 7800.

The Health Care Consumers’ Association work on Advance Health Care Planning is mainly ACT based. However, the organisation also caters to the broader capital region and is qualified to meet the ACP needs of New South Wales residents and to interpret cross-border terminology.

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