Planning ahead

Planning ahead means preparing for end-of-life by making important health decisions before losing the ability to make those decisions in the future [1]. There are a number of important things that Aboriginal and Torres Strait Islander people may want to consider when planning ahead for end-of-life including legal, financial and health-related decisions [2]. By planning ahead, a person can communicate their wishes to family, their doctor or health worker before they lose the capacity to make their own decisions [1][2][3]. Planning ahead can also support family members to feel more confident and comfortable to make informed decisions for their loved one, and potentially reduce disagreements between family members [4][5]. One of the first steps to planning ahead is advanced care yarning, which means talking to a doctor, an Aboriginal Health Worker or family about future medical treatment and attitudes, beliefs and values surrounding death [2]. Advance care yarning can help identify a person’s preferences for when they approach end-of-life, such as returning to Country [6].

Aboriginal and Torres Strait Islander people can plan ahead through the preparation of four key documents: a will, power of attorney and enduring guardianship forms, and an advance care plan [1]. By creating a will, a person can determine what will happen to their personal belongings (property, land and money) when they die [7]. A will may include details of traditional knowledge and contain information for funeral arrangements, such as how and where a person would like to be buried [2][7]. A power of attorney is a signed document which permits an allocated person to make financial decisions for someone who is unable to [1][7]. An enduring guardian is someone who can make decisions for a person who has lost the capacity to do so themselves, such as where they live and the healthcare and other services they receive [1]. An advance care plan outlines the beliefs, values and medical wishes of a person’s future health care [8]. An advance care plan differs from an advance care directive; although both terms are commonly used when discussing advance care planning, an advance care directive is a legally binding document that includes the treatment preferences for the end-of-life care of someone aged over 18 years [9]. It is also important to remember that legislation can differ between the states and territories [10][11].

Sensitive communication between health care professionals and patients is an essential component of planning ahead [5]. Discussing end-of-life care can be difficult and it is important to understand that decisions may be resolved over time [8].