Advance Care Directives in Regional and Remote South Australia

The Regional Access Problem

If you live in the Riverland, the Iron Triangle, the Eyre Peninsula, or anywhere outside metropolitan Adelaide, completing an advance care directive involves logistical hurdles that city residents never face. The form itself is free and downloadable — that's the easy part. The hard part is finding an authorised witness, coordinating substitute decision-makers who may live hundreds of kilometres away, and making sure your completed document is accessible to emergency responders in facilities that may run on separate IT systems from Adelaide hospitals.

These aren't theoretical problems. The Advance Care Directives Act 2013 requires in-person witnessing by an authorised professional, and the conflict-of-interest rules disqualify most of the people who are physically closest to you. In a small community, the pool of eligible witnesses shrinks fast.

Finding an Authorised Witness Outside Adelaide

Under the Advance Care Directives Regulations 2014 (updated March 2024), your witness must belong to one of these professional classes: Justice of the Peace, legal practitioner, registered health practitioner, social worker, police officer, or teacher. They also must not be your family member, an appointed SDM, a beneficiary in your will, your treating clinician, or a staff member in a position of authority at your residential care facility.

In regional SA, the most practical option is usually a local JP. The Attorney-General's Department maintains an online JP roll searchable by location — use the South Australian Government's "Find a JP" service or call Justice of the Peace Services on 131 882. Many regional council offices and libraries have JPs available at scheduled times.

If no JP is accessible, a registered nurse or doctor at your local hospital who is not involved in your ongoing care can witness the document. The key word is "not involved" — your regular GP is disqualified if they are currently responsible for your health management, but a different doctor at the same clinic is eligible.

For very remote communities, consider scheduling the witnessing during a planned trip to a regional hub. Some families coordinate signing during medical appointments or court circuit days when JPs are known to be available.

Coordinating SDMs Across Distances

The strict signing sequence — all SDMs must sign their acceptance sections before you sign in front of the witness — creates a coordination challenge when your appointed decision-makers live in different towns or states.

The March 2024 amendments introduced digital signatures for SDMs, which helps significantly. Your SDMs can sign their acceptance sections electronically before you complete the final witnessing step in person. You don't need to gather everyone in the same room.

The practical workflow for regional families:

1. Complete the ACD form with your healthcare instructions
2. Send the relevant SDM acceptance sections to each nominee (email or post)
3. Each SDM signs and returns their completed section (digital signature is legally valid)
4. Compile the full document with all SDM sections attached
5. Present the complete document to your authorised witness for the final signing

The witness must verify that all SDM sections are signed before proceeding. An incomplete document cannot be witnessed.

The My Health Record Upload

This is where regional completion becomes most important. Metropolitan Adelaide hospitals share integrated electronic records, but regional and remote health facilities often operate on separate IT systems. If you're brought into a country hospital unconscious, the clinical team may have no way of knowing your ACD exists unless it's in a nationally accessible system.

My Health Record is that system. After your ACD is signed and witnessed, upload a high-quality PDF scan to your My Health Record via the myGov portal. Navigate to the "Advance Care Planning" section and upload the document there. This makes it accessible to authorised healthcare providers across Australia, subject to My Health Record access controls.

The 2024 amendments explicitly validate digital copies — clinicians can now legally rely on a digital copy in your My Health Record with the same authority as the physical original. This was a critical reform for regional access, because previously some clinicians hesitated to act on a digital version when no paper copy was available.

Storage Redundancy for Remote Areas

Beyond My Health Record, regional residents should build extra redundancy into their storage plan:

• Original document in a secure, accessible location at home (not a locked safety deposit box that no one can access in an emergency)
• Certified copies delivered to your GP clinic, the nearest hospital, and each SDM
• Digital backup on My Health Record (the nationally accessible layer)
• Wallet card noting that an ACD exists and where it's stored — critical when you're far from your regular healthcare providers

If you enter an aged care facility, deliver a certified copy to the Director of Care. Many regional facilities maintain their own internal document registers, and having the ACD on file there prevents delays when clinical decisions arise overnight or on weekends.

Getting Help in Regional SA

Several services can assist regional residents with ACD preparation:

• Service SA centres in regional towns distribute free ACD kits
• The Office of the Public Advocate provides information and support about SDM appointments and disputes

For a structured, self-paced approach to completing your ACD with the correct signing sequence and clinically precise instructions, the South Australia Advance Directive & Living Will Kit was designed to work without a solicitor appointment — useful when the nearest estate-planning lawyer is a three-hour drive away.

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