Advance Care Planning in New Zealand: A Practical Guide for You and Your Whānau

Advance Care Planning is about thinking ahead and talking with the people who matter about the care you would want if illness, an accident or another emergency meant you could not speak for yourself.

It is not about expecting the worst. It is about making your wishes, values and priorities easier for your whānau and health professionals to understand when decisions may need to be made quickly.

What is Advance Care Planning?

Advance Care Planning is an ongoing conversation about what matters most to you. It can include your views about medical treatment, quality of life, where you would prefer to be cared for, and who you would like involved in important decisions.

Your plan might be as simple as talking with your whānau and trusted health professional, or it may include written instructions about future treatment. The important thing is that your wishes are known and can be revisited as your circumstances change.

Why is it important in New Zealand?

When someone becomes seriously unwell or loses the ability to communicate, their loved ones may be asked to support difficult decisions. Without prior conversations, they may be left wondering what the person would have wanted.

Advance Care Planning can reduce some of that uncertainty. It gives your whānau a clearer understanding of your values and helps your health care team provide care that is consistent with your wishes, as far as possible.

What could you think about?

You do not need to answer every question at once. Start with the things that feel most important to you:

• What makes life meaningful for you?
• What would you consider an acceptable quality of life?
• Are there treatments or situations you would find particularly difficult?
• Where would you prefer to receive care if you were seriously ill?
• Who would you trust to support or speak for you if you could not communicate?
• Are there cultural, spiritual or personal practices you would want your care team to understand?
• What would you want your whānau to know about your wishes?

Advance directives and enduring powers of attorney

In New Zealand, an advance directive can be used to record a person’s decisions about future health care, including a refusal of particular treatment. It is important that any written directive is clear, reflects your current wishes and is discussed with your health professional.

An enduring power of attorney for personal care and welfare is a separate legal arrangement. It allows you to appoint someone to support decisions about your personal care and welfare if the arrangement becomes active. An enduring power of attorney does not replace your own conversations or written health care wishes, so it is worth understanding how these arrangements work and seeking appropriate legal advice.

How to begin the conversation

Choose a calm time rather than waiting for a crisis. You could begin with a simple question such as, “If you became very unwell, what would be most important for us to know?”

Listen as well as talk. People may have different views about treatment, independence and what makes life worth living. The goal is not to make every decision immediately. It is to understand one another and create a starting point for future conversations.

Once you have discussed your wishes, share the information with the people who may need it. This could include your whānau, your GP or other health professionals, and the person you have chosen to support you. Keep any written documents somewhere they can be found, and review them after major changes in your health, relationships or circumstances.

Official New Zealand resources and online tools

The My Advance Care Plan online tool can guide you through important questions and help you record your wishes to discuss with your whānau and health care team.

Health New Zealand | Te Whatu Ora also provides Advance Care Planning guidance. Check the current information and speak with your health professional if you are unsure which documents or steps are appropriate for your circumstances.

A thoughtful gift to your future self

Advance Care Planning is one of the most practical and caring things you can do for yourself and your whānau. It does not remove uncertainty, and it cannot predict every situation. What it can do is make your priorities clearer and give the people around you greater confidence that they are respecting what matters to you.

You can start small, have one conversation and return to it over time. The earlier you begin, the more time you have to ask questions, make informed choices and make sure your voice is heard.

This article provides general information only and is not a substitute for medical or legal advice. Speak with your GP, health care team or a suitably qualified legal professional about your own circumstances.