ACT Advance Care Planning Checklist: Every Step From Start to Finish

Advance care planning in the ACT involves three separate instruments, each governed by different rules, and the order you complete them matters. Missing a step or getting the sequence wrong can invalidate the entire plan.

Step 1: Confirm Capacity and Residency

Before anything else, the principal (the person making the plan) must be at least 18 and have decision-making capacity. Under Section 9 of the Powers of Attorney Act 2006, this means understanding the nature and effect of the documents — specifically that attorney powers continue during subsequent incapacity.

If there is any doubt about capacity (early dementia, cognitive decline, mental illness), get a written cognitive assessment from a medical practitioner before proceeding. An EPoA executed without capacity is void, and that void is typically discovered at the worst possible moment — when the principal is in hospital and the attorney tries to act.

Step 2: Choose Your Attorneys

Select one or more trusted adults for your Enduring Power of Attorney. Decide which powers to grant:

• Property and financial — managing bank accounts, investments, paying bills, selling property
• Personal care — decisions about living arrangements, daily care, social activities
• Healthcare — consenting to or refusing medical treatment (activates only on loss of capacity)

You can appoint the same person for all categories or split them. You can also appoint attorneys to act jointly (must agree on every decision) or severally (each can act independently). Consider naming a substitute attorney in case your primary choice cannot serve.

Step 3: Draft the Enduring Power of Attorney

Use the current approved form: Form AF2017-45 from the ACT Legislation Register. Complete every section, including the specific powers you are granting and any conditions or limitations.

Step 4: Draft the Health Direction

Use the current approved Form AF2017-46 to document your binding treatment refusals. Be specific: name the treatments you want withheld or withdrawn (CPR, mechanical ventilation, artificial hydration, blood transfusions). General statements like "no heroic measures" lack the clinical specificity that forces compliance.

Remember: the Health Direction can only cover refusals and withdrawals. Positive treatment requests go in the Statement of Choices.

Step 5: Complete the Statement of Choices

The Statement of Choices form is included in the ACT Advance Care Planning Booklet from Canberra Health Services. This non-binding document captures your values, preferences, and quality-of-life thresholds. While it does not carry legal force, clinicians are required to take it into account when making treatment decisions on your behalf.

Cover the specifics: what cognitive states you find unacceptable, whether you want to die at home or in hospital, your religious or cultural preferences, and any care goals beyond pure medical treatment.

Step 6: Execute With Proper Witnessing

For the EPoA: two witnesses present simultaneously. Witness 1 must be authorised to witness a statutory declaration (solicitor, JP, notary, medical practitioner). Only one witness can be a relative of the principal or attorney. Every appointed attorney must sign their Acceptance of Appointment.

For the Health Direction: two adult witnesses, both present when the principal signs. No prescribed-professional requirement applies.

Execution order matters: if the documents are inconsistent, section 19 of the Medical Treatment (Health Directions) Act 2006 gives priority to the EPoA when it was made after the Health Direction, and to the Health Direction when it was made after the EPoA. If you want the Health Direction to control an attorney's later treatment decision, sign the EPoA first, then the Health Direction.

Step 7: Distribute and Register

• Upload certified copies to MyDHR (the ACT patient portal) or email them to the Canberra Health Services CPF scanning registry
• Upload to My Health Record for cross-jurisdictional visibility
• Give copies to all appointed attorneys, your GP, and any specialists
• Optionally deposit the original EPoA with the PTG for safe custody ($220–$228)
• If property transactions may be needed, register the original EPoA with Access Canberra Land Titles ($110)

Step 8: Annual Review

Review all documents annually or after any significant health change. To update, execute a new document — handwritten amendments on existing documents invalidate them. If you revoke a document that was registered with the PTG or Land Titles, file the revocation with those registries too.

The ACT Advance Directive & Living Will Kit provides the full execution blueprint with witnessing verification checklists, a document distribution tracker, and a values conversation worksheet to help you work through Step 5 with your family before you sit down with the forms.

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