Supporting advance care planning in primary care

National Palliative Care Week is an opportunity to highlight the need for more Australians to consider their end of life choices by engaging in advance care planning, something which can be supported by their GP.

Primary care is set to play a larger role in advance care planning, particularly with the imminent implementation of the Voluntary Assisted Dying Act in Western Australia from 1 July 2021.

A recent national study found 70% of Australians aged 65 and over are missing the opportunity to consider their end of life care, and of those who do have advance care planning documentation in place, about 30% is incomplete, invalid or non-legally binding.

WA Primary Health Alliance Aged Care Senior Policy Advisor, Lisa Ryan, said while these statistics are concerning, it is a reminder of the importance of having plans in place well before a person is no longer competent to make, or communicate, decisions for themselves.

“This is where the enduring and trusting relationship between a GP and their patient is invaluable.  A great time for this conversation to happen can be as part of a Health Assessment for people aged 75 and over, but it can, of course, happen at any time.”

“Patients will readily confide in and take advice from their family doctor, so it is vital to provide GPs with the necessary information and tools to support their patients to achieve their end of life goals.”

WA Primary Health Alliance is supporting general practice through clinical information, training and education on advance care planning.

“In addition, our Advance Care Planning Health Pathway and related pathways are designed to help GPs make informed clinical decisions.”

WA Health is undertaking consultation on the development of a standardised format for the Advance Health Directive, a legally binding document that specifies the care a person would like in the future, including decisions about resuscitation, mechanically assisted ventilation and assisted nutrition and hydration.

It is hoped creating a standardised format will lead to an increased uptake of advance care planning across Western Australia.

As well as palliative care and advance care planning, it is important that GPs consider referring to Aged Care Assessment Team (ACAT) for short-term restorative care (STRC) and transitional care (TCP), which can be useful in helping people to retain as much independence as they can for as long as possible.

For more information on advance care planning for people, families and carers visit WA Health.

For more information on advance care planning for health professionals, visit the links below.

The RACGP offers information for GPs on the differing Advance Health Directives between states and territories in Australia:

Advance Care Planning Australia has resources for consumers that helps them to prepare for and document their preferences for future health care:

End of Life Essentials provides online learning opportunities and practice resources for GPs, nurses and allied health professionals to improve the quality and safety of end-of-life care in hospitals:

WA DoH Advance Care Planning provides information to consumers about the choices available to them in Western Australia:

Cancer Council WA Palliative Care and Supportive Care Education for Health Professionals offer a variety of programs which are aimed at increasing knowledge and understanding of palliative care in all settings:

Palliative Care WA Advance Care Planning Community Workshops outlines the components of advance care planning in a safe and appropriate environment: