Advance Care Planning Policy Template for Aged Care

Free policy template aligned to Standard 5 of the Strengthened Aged Care Quality Standards

Advance care planning (ACP) is one of the most meaningful — and most regulated — aspects of aged care. It gives residents the opportunity to document their values, wishes, and preferences for future medical treatment and end-of-life care, ensuring their voice is heard even when they are no longer able to speak for themselves.

Under the Strengthened Aged Care Quality Standards and the Aged Care Act 2024, providers have a clear obligation to support residents to engage in advance care planning and to ensure those plans are documented, accessible, and acted upon. A robust, written policy is the foundation of this obligation.

Why Aged Care Providers Need an Advance Care Planning Policy

Standard 5 — Clinical Care explicitly requires providers to have systems in place to ensure care aligns with each resident's expressed wishes, particularly during deterioration, acute illness, and at end of life. The ACQSC assesses this during audits by reviewing whether:

• Residents have been offered the opportunity to engage in ACP on admission and at regular review
• Advance Care Directives (ACDs) and Advance Care Plans are documented and accessible in the resident's record
• Staff know how to locate and act on ACP documentation in an emergency
• Substitute decision-makers are identified and their authority documented
• Palliative and end-of-life care is consistent with the resident's documented wishes

Without a documented policy, providers risk inconsistent practice, missed advance care conversations, and non-compliance findings during assessment.

What's Included in This Policy Template

• Policy purpose, scope, and guiding principles
• Definitions (Advance Care Directive, Advance Care Plan, Substitute Decision-Maker, Medical Treatment Decision Maker)
• Responsibilities — Board, management, clinical staff, and residents
• Procedure for initiating, documenting, and reviewing advance care planning conversations
• How to manage conflicts between documented wishes and family/staff preferences
• Emergency access protocols for ACP documents
• Links to state/territory-specific Advance Care Directive forms
• Related policies and references
• Review and version control section

State and Territory Considerations

Advance Care Directive legislation varies by state and territory in Australia. This policy template provides a nationally applicable framework, but you must customise the relevant sections to reflect the laws in your jurisdiction:

• VIC: Medical Treatment Planning and Decisions Act 2016
• NSW: Advance Care Planning Guide (non-statutory) + Guardianship Act 1987
• QLD: Advance Health Directive under the Powers of Attorney Act 1998
• SA: Advance Care Directives Act 2013
• WA: Advance Health Directive under the Guardianship and Administration Act 1990
• TAS, ACT, NT: Relevant state/territory legislation applies

Standards Alignment

• Standard 5 — Clinical Care: Advance care planning, palliative care, and end-of-life care
• Standard 1 — The Person: Resident rights, autonomy, and self-determination
• Standard 2 — The Organisation: Clinical governance and risk management
• Standard 4 — Care and Services: Person-centred care planning and review

Download the Free Advance Care Planning Policy Template

Download the complete policy template below. Customise it for your state or territory, your facility size, and your clinical governance framework. For automated policy mapping to the Strengthened Standards, explore Governa's Policy Mapping feature.