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Learning modules

Activity 5: Advance care planning

Advance care planning is an ongoing process which can be constantly reviewed within a changing clinical context. Advance care planning is a term used to describe the process whereby a person thinks about and plans for their future medical care should they become unable to communicate. Advance care planning promotes open and ongoing communication between patients, their families and health care professionals about end of life decisions. [1]

Engaging in Advance Care Planning Discussions

Advance care planning discussions may be challenging as issues around death and dying emerge. Therefore it is important that the health professionals who are instigating and facilitating these discussions have excellent communication skills.

Key points

  • Ensure that end-of-life goals have been established.
  • Provide a clear definition of advance care planning.
  • Explain the benefits of advance care planning to the individual and family.
  • Ensure that the caregiver who may be making decisions in the future understands the advance care planning process and the person’s end-of-life goals. [2]
  • Encourage the individual to think about:
    • the values that are important in their life
    • their treatment and care preferences
    • their current health and possible future health problems
    • what they would want from future medical care
    • their limitations. [1]
  • Arrange a family meeting if required.
  • Document discussions to ensure that all parties are aware.
  • Complete an advance directive as appropriate.

Thinking points


1. Respecting Patient Choices. (2010). Advance care planning for everyone. Retrieved November 6, 2017, from  

2. Clayton, J., Hancock, K., Butow, P., Tattersall, M., Currow, D. (2007). Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. MJA, 186 (12), S77-108.