Advance Care Planning Support Guide for Aged Care Staff
Advance care planning (ACP) empowers consumers to document their values, preferences and decisions about future care — ensuring their voice is heard even when they can no longer communicate directly. For aged care providers, facilitating and honouring ACP is both a Standard 1 obligation and a fundamental act of respect. This guide walks your team through the ACP process from first conversation to documentation to review.
What This Guide Covers
- What advance care planning is and why it matters in aged care
- Legal frameworks — advance care directives, enduring guardianship and power of attorney
- Who is a Substitute Decision-Maker (SDM) and when they are involved
- Initiating ACP conversations — timing, language and approach
- Documenting ACP outcomes in the care record
- Reviewing and updating ACP as health status changes
- State and territory differences in ACP legislation
- When ACP conflicts with family wishes — how to navigate
Key Learning Outcomes
- Explain what advance care planning is and the documents that form part of it
- Identify the consumer's Substitute Decision-Maker and understand their authority
- Facilitate a respectful ACP conversation appropriate to the consumer's capacity
- Ensure ACP documentation is accurately recorded and accessible to the care team
- Recognise when ACP should be reviewed and initiate that process
Who Should Complete This Training
Registered Nurses, clinical leads, care managers and any staff involved in care planning conversations. PCAs should have a working understanding of ACP and know how to escalate ACP questions to clinical staff.
Alignment to the Strengthened Aged Care Quality Standards
Directly relevant to Standard 1 (The Person) — the right to make decisions about one's own care — and Standard 4 (Care and Support), which requires care plans to reflect the consumer's goals, preferences and advance care wishes.
Make ACP Documents Accessible Across Your Team
Governa helps aged care teams ensure advance care plans are linked to resident records and accessible to the right staff at the point of care. Ask Norma to surface your ACP policy in seconds.
