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If you can’t make your own decisions, who will make them for you?
You can decide:
• Whatmedicaltreatmentyouhavebymakinganadvance health directive.
• Whowillmakeyourlifestyleandmedicaltreatmentdecisionsbymakinganenduring power of guardianship.
• Whowillhelpyouandmakedecisionsaboutyourmoneybymakinganenduring power of attorney.
Thesearewaysthatyoucanplanforyourfuture.
Why do I need to plan ahead?
Everyonehopesthattheywillstayhealthyandwellandwillnotneedanyhelp.
Whenyouarewell–mentallyandphysically–youmakeyourowndecisionsandlookafteryourself.Whenyoucandothisyouhavefullcapacity.
Butsometimessomethingcanhappentoyourbrain–youcouldhaveanaccidentorgetsickandnotbeabletomakeyourowndecisions.
Ifthishappens,youhavelostcapacityandsomeoneelsemightneedtomakedecisionsforyou.
Ifyouplanaheadyoucanchoosethepersonwhowillmakedecisionsforyouif,foranyreason,youarenotabletomakethemforyourselfinthefuture.
How could I lose capacity?
Therearemanyreasonswhyyoucouldlosecapacitytomakedecisionsforyourself,including:
• dementia(adiseaseofthebrain)
• acquiredbraininjury(aresultofafallorcaraccident)
• substancerelatedbraindamage(aresultofusingtoomanydrugsordrinkingtoomuchalcohol)
• mentalillness(anillnessofthebrainlikedepressionorschizophrenia)
• intellectualdisability(usuallyfrombirth,forexampleDown’sSyndromeorfoetalalcoholsyndrome).
Ifyoulosecapacity,youmaybetoldyouhaveadecision-makingdisability.
What does it mean to have a decision-making disability?
Havingadecision-makingdisabilitymeansthatyoucan’tunderstandwhatthedoctororhealthworkerorothersaretellingyouaboutyoursituationandthedifferentchoicesthatyoucouldmake.
I want to plan ahead – what can I do?
Therearethreewaysthatyoucanplanahead,andchoosehowyourdecisionswillbemadeifyoulosecapacitytomakedecisionsforyourselfinthefuture.
1. An advance health directive
Inthisdocumentyoucanwritedownyourdecisionsabouttreatmentandotherhealthcare.Youcandecidenowwhatmedicaltreatmentyoudoordonotwanttobegivenifyoulosecapacity.
Talktoyourdoctororhealthworkeraboutyourviewsandwishes.Yourdoctororhealthworkercanhelpyouwritedownwhattreatmentyoudoordonotwanttobegiveninthefuture.
Theseinstructionsinyouradvancehealthdirectivewillbefollowedbythedoctorifyoucan’tmakethedecisionforyourself–sothisisawaytomakesureyourwishesabouttreatmentarefollowed.
2. An enduring power of guardianship
Inthisdocumentyoucannamethepersonwhoyouchoosetomakedecisionsaboutyourlifestyleandmedicaltreatmentifyoulosecapacity.
Thepersonyouchoosetoappointasyourdecision-makeriscalledanenduring guardian.Theyareonlyallowedtomakedecisionsifyoulosecapacity.
Yourenduringguardiancanmakedecisionsabout:
• whereyoulive,andwhoyoulivewith
• medical,dentalandotherhealthtreatment
• services
• contactwithothers.
3. An enduring power of attorney
Inthisdocumentyoucannamethepersonwhoyouchoosetomakedecisionsaboutyourfinances.Thepersonyouchoosetoappointasyourdecision-makeriscalledanattorney.
Itisuptoyoutodecidewhenyourattorneycanhelpyouwithyourfinancesandmoneymatters.Youcangivethemtheauthoritytostarthelpingyouimmediately,oronlytomakefinancialdecisionsforyouifyoueverlosecapacity.
Iftheystarthelpingyouwhileyoustillhavecapacity,youwilltellthemwhattodo.Thiscanbeusefulifyoufindithardtogotothebanktopaybills.
Yourattorneycanmakedecisionsabout:
• pension
• everydayexpensesandbills
• saleorleaseofproperty.
What are the rules for making these documents?
Whenyoucompletethesedocumentstoplanforthefutureyoumust:
• beatleast18yearsofage
• havefullcapacitywhenthedocumentissignedbyyou
• usetherightform–theformsareavailablefromthewebsiteslistedattheendofthisbrochure
• signtheform,andtwopeoplemustwitnessyoursignature.
Oneofthepeoplewhowatchesyousigntheformmustbeanauthorisedwitness,suchasyourdoctororbankmanager.ThereisalistofpeopleauthorisedtowitnessyoursignatureontheOfficeofthePublicAdvocate’swebsite:www.publicadvocate.wa.gov.au
Who do I tell about the plans I have made?
Ifyoudecidetomakeanyofthesedocumentstoplanforthefutureitisuptoyouwhoyoutell.
Itmaybeagoodideatotalktoyourfamilyandfriendsaboutyourplans.
Thiswillmeaneveryoneknowsaboutyourchoicesandunderstandswhatyouwanttohappenifyoulosecapacityandcan’tmakeyourowndecisionsinthefuture.
Do I have to fill in these documents?
No–itisuptoyoutodecideifyouwanttouseanyofthemtohelpplanforthefuture.
No one can force you to fill them in.
Ifyouareworriedbecausesomeoneisforcingyoutofilltheminwhenyoudonotwantto,youshouldtalktosomeoneyoutrustwhocanhelpyousay‘no’tothatperson.
If I don’t want to make these documents, how will decisions about my health and medical treatment be made if I can’t make them for myself?
Ifyouarenotabletomakedecisionsforyourselfandyouneedtreatment,thedoctorwillasksomeoneonthelistofdecision-makerstomakethedecisionaboutyourtreatment.Thislistissetoutopposite.
Thedoctorwillgetthedecisionfromthefirstpersononthelistwhoisatleast18yearsold,hasfullcapacityandwhoiswillingandavailabletomakethedecision.Thislistiscalledthe‘Hierarchyofdecisionmakers’.
What happens if I need urgent treatment and no one is around to talk to the doctor?
Ifyouneedurgenttreatmenttosaveyourlifeorpreventyoubeinginpain,thedoctorcantreatyouwithoutspeakingtofamilyorfriends.
Afterthisthedoctorwillneedtofindsomeonewhocanmakeadecisionaboutanynon-urgenttreatmentthatyouneed.Thedoctorwillgetthedecisionfromthefirstpersononthelistbelow.
Hierarchy of decision makers
Advance Health DirectiveDecisionsmustbemadeinaccordancewith
theAHDunlesscircumstanceshavechangedorcouldnothavebeenforeseenbythemaker.
Enduring Guardian withauthority
Guardian withauthority
Spouse or de facto partner
Adult son or daughter
Parent
Sibling (a brother or sister)
Primary unpaid caregiver
Other person with close personal relationship
WhereanAdvanceHealthDirective(AHD)doesnotexistordoesnotcoverthetreatmentdecisionrequired,thehealthprofessionalmustobtainadecisionfornon-urgenttreatmentfromthefirstpersoninthehierarchywhois18yearsofageorolder,hasfulllegalcapacityandiswillingand
availabletomakeadecision.
What happens if I have looked at the list and I do not think that the person the doctor should contact is the person I want to make treatment decisions for me? What can I do?
Itispossiblethatthepersonthedoctorshouldcontactisnotthepersonyouwanttomaketreatmentdecisionsforyou.Thiscouldbefordifferentreasonssuchas:
It is not the way it works in your culture or family–Forexample,thepersonthedoctorshouldcontactasstatedonthelistisyourdaughter,butculturallyyourbrothershouldmakedecisionsforyouifyouarenotabletomakethemforyourself.
Someone else knows more about you–Forexample,thepersonthedoctorshouldcontactasstatedonthelistisyourdaughter,butyouhavenotseenherforalongtimeandyourfriendsknowyoubetter.
The person on the list does not have the same views and opinions as you do about medical treatment–Forexample,thepersonthedoctorshouldcontactasstatedonthelistdoesnotagreewithdoctorsgivingabloodtransfusion,butyouknowyouwouldwantthisifitwasneeded.
Where can I get help and more information about these three ways to plan for the future?
The Department of Health
TheDepartmentofHealthcanprovideinformationandabookletontheadvancehealthdirective.
Thebookletandformcanalsobedownloadedfromthewebsite:www.health.wa.gov.au/advancecareplanning
T:92222300
E:acp@health.wa.gov.au
The Office of the Public Advocate
TheOfficeofthePublicAdvocatecanprovideinformationandabookletontheenduringpowerofguardianship.
Theenduringpowerofguardianshipandtheenduringpowerofattorneybookletsandformscanbedownloadedfromthewebsite:www.publicadvocate.wa.gov.au
T:1300858455
E:opa@justice.wa.gov.au
Thisdocumentcanbemadeavailableinalternativeformatsonrequestforapersonwithadisability.
2015
Ifyouthinkthelist(calledthe‘Hierarchyofdecisionmakers’)meansthedoctorwillnottalktotherightperson,thisisagoodreasonforyoutothinkaboutmakinganenduring power of guardianshipbecauseyoucan:
• Choosewhoyouwanttomakedecisionsaboutyourlifestyleandmedicaltreatment–andgivethemlegalauthoritytobeyourdecision-maker.
• Makesurethatpersonistherightpersontotalktoinyourfamilyorculture.
• Makesureyourfamilyandyourdoctorsknowwhoyouhavechosentomakedecisionsaboutyourlifestyleandtreatmentforyourhealth.
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