Science & Medical |
Advance Care Planning Australia

Most older Australians unprepared for end-of-life decisions

New research from Advance Care Planning Australia (ACPA) reveals that 70% of older Australians are without an Advance Care Directive, leaving no instructions in the event that they’re unable to make their own medical decisions. 

Funded by the Australian Government, this landmark study was recently published by BMJ Open and is the largest and most comprehensive study into the prevalence of Advance Care Directives in Australia.

The study involved reviewing de-identified health records at the point-of-care in 51 Australian hospitals, aged care facilities and GP clinics, across six states and territories.

The study found that approximately 30% of people reviewed had an Advance Care Directive – of which some had documented their preferences for care, others had appointed a substitute decision-maker – a person legally empowered to make decisions of their behalf -  and some of whom had done both.

 “With Australia’s ageing population, it’s concerning that most older Australians are leaving it to chance and not taking active control of their future health care, said Dr Karen Detering, Medical Director of Advance Care Planning Australia.

 “Without a plan, older people may be left vulnerable and potentially without a voice. And far too often loved ones are left to blindly make decisions under the worst circumstances. As a medical practitioner I’ve witnessed these scenarios and I can tell you it’s a heart-breaking way to say goodbye to your loved ones.

“The research findings are a great starting point for us to better understand the Australian advance care planning landscape. This valuable baseline data will be used to inform policy in advance care planning, which is becoming an increasing healthcare priority,” explained Dr Detering.

As the national authority on advance care planning, ACPA is continuing research into advance care planning prevalence with a view to better understanding the barriers and enablers and to increase uptake in Australia.

To increase public awareness, ACPA’s National Advance Care Planning Week initiative runs from 1 – 5 April 2019, encouraging all Australians to make sure their care preferences and values are heard and respected.

Read study online                                                             
Learn more about
National Advance Care Planning Week, 1 – 5 April 2019.



What is advance care planning?
Advance care planning promotes care that is consistent with your goals, values, beliefs and preferences. It prepares you and others to plan for future health care and a time when you may no longer be able to communicate those decisions yourself. 

Key facts

  • Almost 50% of people will not be able to make their own end-of-life medical decisions[1]
  • A third of Australians will die before the age of 75[2]
  • Most people die after a chronic illness, not a sudden event3
  • Advance care planning can reduce anxiety, depression and stress experienced by families and that they’re more likely to be satisfied with their loved one’s care[3]

About Advance Care Planning Australia
Advance Care Planning Australia (ACPA) is a national program funded by the Australian Government, Department of Health, enabling Australians to make the best choices for their life and health care.

ACPA increases advance care planning resources across health sectors and NGOs, improves workforce capability, produces information resources for diverse consumers and communities, and builds the evidence base.

Media enquiries
Rebecca Camilleri
Advance Care Planning Australia
phone: 0407 832 093  |  03 9496 5660

[1] Silveira MJ, Kim SY and Langa KM. Advance directives and outcomes of surrogate decision making before death. New England Journal of Medicine. 2010; 362: 1211-8.

[2] Australian Bureau of Statistics. Deaths, Australia, 2016. Available at (last accessed 17 April 2018).

[3] Detering KM, Hancock AD, Reade MC and Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. Bmj. 2010; 340: c1345.