Digital Advance Care Plans for Margaret

An Advance Care Plan is a document that sets out any medical treatment you do or do not consent to – in advance, to be relied on only in the event you lose decision-making capacity.

An Advance Care Plan can also set out your values. That is, those things that are important to you (and which may influence your choices) – such as being able to communicate with your loved ones. Setting out your values can help inform your doctors, carers and substitute decision-makers about what treatment you would or would not have consented to.

If one day you lose decision-making capacity, an Advance Care Plan can assist those involved with your care to make treatment decisions on your behalf by informing them of your wishes. It is therefore important you share your Advance Care Plan with others so it is readily available in the event you lose capacity (which can happen suddenly and unexpectedly, such as in the case of a head injury).

Your Advance Care Plan can inform your family and doctors what specific treatments you do and do not want. It can also inform them what your values are, so they can be guided in deciding what treatment you would or would not have wanted (if such treatment is not specified in your Advance Care Plan). An Advance Care Plan will assist your family or doctors in making decisions about your medical treatment that are in line with your preferences in the event you cannot speak for yourself.

An ‘Advance Care Plan’ is separate and distinct from a document prepared by health practitioners to plan your care, which is often referred to as a ‘Care Plan’. An Advance Care Plan is not to be confused with a Care Plan (which should include an Advance Care Plan).

While a Care Plan should be prepared taking your preferences into account (particularly if you are in aged care), it is not an Advance Care Plan. An Advance Care Plan can only be completed by you, and sets out your choices only. It does not include an assessment of your needs, which a Care Plan does. While an Advance Care Plan may be completed with support from health practitioners, it cannot be completed by them.

Without an Advance Care Plan, you leave some of the most important choices of your life in other people’s hands. You’re immensely vulnerable.

Your medical team may want to save your life and administer interventions you would not have wanted and which, arguably, prolong your suffering.

Or there may be conflict and therefore delay about giving you treatment which you did want.

Your family might not know what to do either. One of your children might think everything that can be done should be done, while the other might think it’s better to spare you further trauma. After all you’ve done to create a strong family, you could end up unintentionally leaving a legacy of conflict, on top of grief.

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They love you. You can’t spare them the pain of loss – that’s an inevitable, healthy part of loving someone. But you can spare them the pain of seeing you receive care they don’t think you’d want or from arguing with one another or your doctors about what would be best for you.

Only 7.6% of people with malignant cancer have a statutory advance care directive outlining their preferences for care.

Having a Touchstone Life Care Advance Care Plan, means you have clearly articulated your wishes so that everyone involved knows what matters to you.

You’ve named substitute decision makers and given them authority to decide on treatment that’s in accordance with your plan.

You’ve protected your loved ones from the stress of working out what you would want when you can no longer speak for yourself.

And you’ve protected yourself from being put in a situation you would never have chosen.

If you don’t yet have an Advance Care Plan, it’s time to get one.

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Yes of course. The link to each State’s form you can find below.

They are very useful if you like to print and write out your plan manually. Please make sure you work your way through the whole form and do not leave it unfinished. This creates problems for both your doctors and your family and can lead to unnecessary suffering. Also make sure you photocopy several copies, write the date clearly and mail all pages, and/or scan and email to everyone who will need a copy. You’ll need to repeat this process every time you need to make any changes to your plan and every 12 months. Don’t forget to ask your family to delete or throw out the old outdated copies of your plan when you make changes. You’ll also need to make sure they know where there will be a copy of your most recent plan available, wherever you are, even in the middle of the night, in an emergency.

Since paper based Advance Care Plans were created, health and aged care Providers have moved on to digital systems for ease and efficency. TLC provides a solution that works with these systems so your Advance Care Plan can be on your phone, on your carer’s iPad, on your GP’s computer screen, in your hospital notes and on a QR code for your ambulance officer to scan, without you, your family or your carer needing to go through all the paper work.

Here are all of the state based paper forms:

• ACT
• NT
• NSW
• VIC
• TAS
• SA
• WA

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Touchstone Life Care’s Advance Care Plan has been designed with 2 key audiences in mind: you and your doctors.

It helps you identify and explain your values and preferences for care through a guided conversation that starts with gentle questions and builds up to the trickier ones.

Once you’ve completed your Plan, the program rearranges the layout to present the most crucial medical information on the front page so your doctors can quickly find out what you want in an emergency.

With Touchstone Life Care, you benefit from: 

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Yes, under the Aged Care Quality Standard 2(3)(b) you can claim for cost of your Touchstone Life Care Advance Care Plan from your Home Care Package provider. Simply speak to your provider today.

Yes.

A Touchstone Life Care Advance Care Plan is:

Legally valid as a Common Law Advance Care Directive.
A legally valid expression of your wishes.
Must be considered by health professionals when making decisions about you.
An expression of your consent or your refusal of consent to medical care.

The idea of advance care directives or advance care plans has been around for a long time. No matter whether you call it an Advance Care Directive or an Advance Care Plan they are a valid expression of a person’s consent or of their refusal of consent, in advance of incapacity. Incapacity means you have lost the capacity to make or speak your decisions or wishes.

Your advance care directive or plan can only be used to make decisions about your care when you cannot- ie when you lose capacity.
Health practitioners are obliged to consider any expression of a person’s wishes for medical care. They cannot ignore an expression of consent or refusal of consent no matter what form is used.
Touchstone Life Care’s Advance Care Plans are not the same as a Statutory directive, which are different in every state, (and do not exist at all in NSW and Tasmania) These have a variety of names- some are called Health Care Directives, others a State Advance Care Directive or Personal Statement of Health.

Touchstone Life Care’s unique automated sharing system grants additional legal validity to your plan because your trusted contacts can see, read and discuss the plan ahead of time, thereby vouching that it was prepared without coercion, and that you had capacity at the time you made it. Or, if there is any doubt about your plan they can contact you or the other contacts listed to discuss their concerns about it.

An Advance Care Plan might also be referred to as an Advance Care Directive, Living Will, or Statement of Choices. In different parts of Australia it is also known as an Advance Health Directive, Health Direction or Advance Personal Plan.

If you are 18 years and over, you are presumed to have decision-making capacity. No one will question this unless there is a reason to.

Even so, at some stage your decision-making capacity may become impaired by disease or injury, or even drugs or alcohol. You might lose decision-making capacity permanently (for example, if you sustain serious irreversible brain damage), or temporarily (for example, if you are put into an induced coma).

In order to have decision-making capacity, you must be able to:

• Understand the nature of the decision that is being made (including the information provided to you in relation to that decision);
• Understand the risks and consequences of the decision (and be able to weigh them up); and
  
• Be able to communicate the decision (whether verbally or otherwise).

If there is any doubt as to your decision-making capacity we strongly recommend you have this confirmed by your GP and upload their summary report with your Advance Care Plan. This will offer reassurance to anyone seeking to rely on your Advance Care Plan later, that you understood your decisions when making them.

It will increase the likelihood that your Advance Care Plan will be complied with, and your wishes followed. Remember that even if you have dementia or are unable to understand some things, it does not necessarily mean you do not have decision-making capacity to make an Advance Care Plan.

However if there is any reason your decision-making capacity might be impaired, it is even more important to have a formal assessment by your GP.

We urge everyone who is 18 years or over to prepare an Advance Care Plan, even if you are fit and well.

Advance Care Plans have even greater importance in certain circumstances, for example if:

• you are elderly or frail;
  
• you have a chronic illness;
  
• you have multiple diseases;
  
• you have an early cognitive impairment;
  
• you are admitted into a care home or hospital;
  
• you are approaching your end of life;
  
• you are about to be admitted to hospital or have major surgery.
  

Life is unpredictable. It is therefore best to prepare your Advance Care Plan while you are healthy, to ensure you have time to discuss your wishes with family, doctors and trusted advisors.

Even if you are young, fit and healthy, you should make an Advance Care Plan if you have wishes about your medical treatment. However note that Touchstone’s Advance Care Plans are only available to people aged 18 or over.

Advance Care Plans are not only important in the context of ‘end of life’ situations. The unexpected can happen. An Advance Care Plan will become important if any time you lose decision-making capacity, even temporarily.

For example, you might lose consciousness after an accident and need a blood transfusion. Through an Advance Care Plan you can refuse consent to this if it is contrary to your beliefs, even if it would be life-saving. You can also confirm consent to a blood transfusion (regardless of your beliefs), to avoid any confusion later.

If you have decision-making capacity, your Advance Care Plan cannot be used and consent must be obtained from you directly.

An Advance Care Plan only comes into effect if you become unable to make or communicate your own decisions regarding medical treatment, and only in circumstances covered by the Advance Care Plan. It is there ‘just in case’ it is needed. If you are lucky, it might not ever be needed.

Your Advance Care Plan may be used if you temporarily lose decision-making capacity. However, once you regain it your Advance Care Plan will no longer be relevant and consent will only be sought directly from you.

An Advance Care Plan will not cover all treatments – only the ones you specify. It is important to as clear and specific as possible about what treatments you do and do not want.

An Advance Care Plan also cannot compel a health practitioner to withhold palliative care, assist you to die, or give you treatment which is futile.

Since it is not possible to cover every conceivable treatment in an Advance Care Plan, Touchstone’s Advance Care Plan allows you to set out what is important to you, and the things you need to live your minimum quality of life – such as being able to communicate with your loved ones. These values will guide health practitioners when treating you by enabling them to assess whether you would have consented to particular treatment in a given circumstance. For example, if life-saving brain surgery would inevitably leave you non-communicative (eg. in a permanent vegetative state) and you have indicated you do not want to live this way, your doctors might decide against performing such surgery.

Note that setting out your values alone (without being specific about treatment) will be open to interpretation. In the example given, a decision to operate could be made if it is believed you might be able to communicate with assistance, and therefore would have consented on the basis of your values.

Therefore if there is treatment you absolutely want to exclude, you must be very specific about that in your Advance Care Plan. The more specific and clear about the treatment you consent or refuse consent to, the greater likelihood you wishes will be followed.

A Will sets out your wishes in relation to your assets after you pass, whereas an Advance Care Plan sets out your wishes in relation to your medical treatment while you are still living. It does not operate after you die, but only after you lose capacity (even temporarily) to make decisions about your medical treatment. This is why sometimes Advance Care Plans are called ‘Living Wills’.

Just as a Will helps plan the future of your assets, an Advance Care Plan helps plan the future of your medical care. Like a Will, an Advance Care Plan becomes operative when you are unable to communicate your wishes. However unlike a Will, an Advance Care Plan is only relevant if you are still alive, as it concerns medical treatment only.

Since your lawyer is usually involved with planning for your future, Touchstone enables you to share your Advance Care Plan with them as well, if you choose to.

An Advance Care Plan is a document which sets out your wishes in relation to medical care. It expresses your consent, or refusal or consent in advance. Unlike powers of attorney or guardianship, an Advance Care Plan in itself does not empower another person to make a decision for you.

A person who makes medical treatment decisions on your behalf, if you lose decision-making capacity, is generally referred to as a substitute decision maker. A substitute decision maker must have regard to your wishes, including those set out in your Advance Care Plan. This is because a substitute decision maker must decide your medical treatment in accordance with what they believe you would have wanted (and not in accordance with what they believe your best interests are).

Every state and territory in Australia has different laws around powers of attorney and guardianship. Depending on your state or territory and individual circumstances, your substitute decision-maker might be your power of attorney, or a guardian.

Touchstone’s Advance Care Plans enable you to nominate a substitute decision maker.

However, depending on your state or territory, only certain substitute decision makers might be recognised at law. Depending in your state or territory a substitute decision-maker is also known as a medical treatment decision maker or a person responsible.

A health practitioner may be obliged to consult a legally recognised substitute decision-maker rather than the person you nominate on your Advance Care Plan. We therefore strongly recommend you seek advice in your own state or territory as to how to formally appoint a substitute decision maker (or medical treatment decision maker/person responsible), consistent with the person nominated in your Advance Care Plan.

A family member is only entitled to make a medical treatment decision on your behalf if they are also your substitute decision-maker/medical treatment decision maker/person responsible at law.

Your substitute decision maker is legally obliged to consider your Advance Care Plan if you lose decision-making capacity. Even if they are a family member, they cannot ignore your Advance Care Plan.

If you have decision-making capacity, the content of your Advance Care Plan is entirely up to you.

However, if anyone is concerned about your decision-making capacity at the time of making your Advance Care Plan (including your family), they might challenge it. Similarly, a health practitioner might challenge your Advance Care Plan if they doubt its validity, or that it applies to particular circumstances at hand.

Each state and territory has different legal mechanisms to do this, whether by application to a court or tribunal.

A person might challenge your Advance Care Plan if they do not believe it was validly made – for example, if:

• They believe you did not have decision-making capacity at the time of making it;
• They believe you did not understand the nature of the decision/s;
• They believe you did not understand the risks or consequences of your decision/s;
• Circumstances have changed such that your Advance Care Plan no longer appears to apply, or circumstances have arisen which you were unlikely to (or could not have) anticipated at the time of making the Advance Care Plan;
  
• They suspect the Advance Care Plan is fraudulent;
  
• They are concerned your Advance Care Plan may not have been made freely or voluntarily, or that if may have been made with coercion;
  
• The Advance Care Plan is unclear or cannot be understood;
  
• The Advance Care Plan is contrary to other wishes you have previously expressed.

Touchstone Life Care provides a mechanism for you to share your Advance Care Plan. Once you have completed your Touchstone Life Care Advance Care Plan, you can share it via a secure link with your family, doctors and other trusted advisors. This allows them to view a copy of your Advance Care Plan but does not allow them to access, edit or delete the document.

It is your choice whether you share your Advance Care Plan with anyone at all. However we strongly encourage you to do so. We believe that sharing your Advance Care Plan with loved ones will encourage discussion about your wishes, and reduce the risk of confusion and conflict if a time comes when a decision about your medical treatment needs to be made.

Sharing your Advance Care Plan with your family, GP and lawyer will also offer some reassurance to health practitioners that it was validly made, and reduce the risk it will be challenged. Further, it will facilitate access to your Advance Care Plan if it is needed.

Anyone with whom you share your Advance Care Plan will be able to access it at any time by logging onto the secure link which is emailed to them.

We cannot guarantee that your Advance Care Plan will not be challenged by another person. However Touchstone Life Care provides a mechanism for you to share your Advance Care Plan. Once you have completed your Touchstone Life Care Advance Care Plan, you can share it via a secure link with your family, doctors and other trusted advisors. This allows them to view a copy of your Advance Care Plan but does not allow them to access, edit or delete the document.

It is your choice whether you share your Advance Care Plan with anyone at all. However we strongly encourage you to do so.

Sharing your Advance Care Plan with your family, GP and lawyer will also offer some reassurance to health practitioners that it was validly made, and reduce the risk it will be challenged. Further, it will facilitate access to your Advance Care Plan if it is needed.

Anyone with whom you share your Advance Care Plan will be able to access it at any time by logging onto the secure link which is emailed to them.However we recommend the following steps be taken to mitigate the risk:

• Share your Advance Care Plan with as many of your loved ones as possible. That way any concerns or issues can be discussed, to avoid confusion later.
  
• Discuss your Advance Care Plan with your GP to ensure you understand the risks and consequences of your decisions.
  
• If there is any concern about your decision-making capacity, agree to have your capacity assessed by your GP.
  
• Review and confirm or update your Advance Care Plan at least every six months.
  
  

Failure to take these steps may risk treatment decisions being made contrary to your wishes.

You should review your Advance Care Plan as regularly as possible, and amend or revoke it if necessary.

The Advance Care Plan on our system, once completed, will be deemed to reflect your current wishes. Sometimes your circumstances, values or beliefs change, or there might be advances in treatment that impact your decision/s. If this happens, it is important you immediately review your Advance Care Plan and verify, amend or revoke it.

We will send you a reminder every 12 months (at the time your subscription is renewed) to review and update your Advance Care Plan, preferably with the assistance of your GP.

If your Advance Care Plan is more than 12 months old and has not been reviewed, or if circumstances have significantly changed since the last review, there is a risk that:

Someone will comply with your Advance Care Plan when your wishes have changed; or
Someone will challenge your Advance Care Plan on the basis that circumstances have changed.

You can change your mind about your Advance Care Plan at any time. You can amend it, or revoke it completely.

You are the only person who can amend your Advance Care Plan, and while you have decision-making capacity, no one can revoke your Advance Care Plan but you.

As soon as you amend your Advance Care Plan, the last Advance Care Plan you made will be deleted from our system. You must ensure you destroy all hard copies of the old Advance Care Plan and share the updated copy with anyone with whom you shared your previous Advance Care Plan. You must also ask that they immediately destroy and deleted any copies of the old Advance Care Plan in their possession.

If you would like to revoke your Advance Care Plan, you can simply delete your account. Your Advance Care Plan will then not be accessible by anybody.

If you amend or revoke your Advance Care Plan, the people with whom you nominated to share your Advance Care Plan will be automatically and instantly notified by email.

If you lose decision-making capacity, medical treatment may be lawfully given without your consent in an emergency if:

it is not known whether you consent; or
you are not known to have previously refused consent.

In these circumstances, treatment decisions will be made on the basis of your best interests, as assessed by others. However, if you have a valid Advance Care Plan in which you refuse consent to treatment such as a blood transfusion or CPR, you cannot lawfully be given this treatment – even if it is in your best interests.

If a copy of your Advance Care Plan is not immediately available in the event of an emergency, a health practitioner may need to administer life-saving measures until they can contact your next of kin. It is therefore crucial to ensure your loved ones are aware of your Advance Care Plan and understand its contents.

If possible, the hospital will be advised by you or your family when you are admitted. The hospital can also contact your GP if you or your family are unable to tell them. The hospital can be provided with a secure link to your Advance Care Plan either by you, your family, your GP or lawyer. Touchstone Life Care provides a QR Code for you to print and add to your wallet or fridge, or send to your trusted contacts so your plan can be scanned by an emergency worker’s mobile phone

If you choose, you may upload your Advance Care Plan to My Health Records. However if you amend or revoke your Advance Care Plan it is your responsibility to also update My Health Records immediately.

It is recommended that you keep an up-to-date hard copy of your Advance Care Plan in your home, handbag or wallet in case of an emergency.

Touchstone’s Advance Care Plan is intended for use in Australia only. It would be up to health practitioners or carers overseas to decide how much they rely on your Advance Care Plan in the event you lose decision-making capacity.

If you intend to relocate overseas, we recommend you speak to a doctor or lawyer locally about how to make an Advance Care Plan.

If you do not have an Advance Care Plan, then in the event of a serious illness or accident, health practitioners will normally consult your family in making treatment decisions. Family members may need to make harrowing decisions about your care which can cause conflict and delay medical treatment.

If health practitioners are unable to contact your family, then without knowing what your wishes are they will need to make treatment decisions according to what they believe are your best interests.

Having an Advance Care Plan will make your wishes clear so you do not receive treatments you do not wish to have.

It only costs a one-off fee of $149 to use our guided questionnaire to help identify your preferences and create, and share your plan.

Every year thereafter you will only be charged $10 per year to keep the plan online, with unlimited changes, shares and 24/7 access via on-line and QR codes.

You also have the option of purchasing a Lifetime Plan for $350 which is a one-time payment with no yearly costs.  See Pricing for more information on inclusions.

Yes.

You can print your Advance Care Plan and a QR code of it to be scanned by emergency responders if needed.

In case of emergency your Advance Care Plan can be accessed remotely via the secure link provided to your family, doctor and other trusted advisors. It can also be scanned by an emergency worker’s mobile phone if you print the QR code we provide.

Other than this, unless you have provided your login details to anyone, your account is completely secure and protected by Australian Privacy laws.

If you have an account with us you can opt out at any time.

Simply send us an email at info@touchstonelifecare.com and let us know that you want to close and remove your account and all data.

We will be in touch to verify your identity so we can commence the removal.

Before removing your account, we will email you a copy of your Advance Care Plan.

If you do not want to pay the $10 annual fee to keep your plan live and online, you are able to download and print a copy of your plan.

By law, we have to keep a copy of your plan on our system for 7 years should you want to access it, or if you ever change your mind and want to be able to have your plan made digital again.

Yes we do. To read our Privacy Policy simply click here.

Please read our Terms of Use carefully. They can be accessed here.