Advance Care Directive South Australia: What It Is and How to Make One

An Advance Care Directive is not a will. It does not transfer property, name beneficiaries, or appoint an executor. What it does is give you control over your medical care, accommodation, and lifestyle choices when you can no longer speak for yourself — and it gives legal authority to the people you trust to make those decisions. Getting these details right now prevents agonising disputes later.

South Australia has specific rules about what a valid ACD can do, who can witness it, and exactly when it ceases to have legal effect. Here is what you need to know.

What an Advance Care Directive Covers in South Australia

An ACD in South Australia allows you to do two things simultaneously. First, you can record binding instructions about your future health care — including whether you want life-sustaining treatment in specific circumstances, pain management preferences, and where you want to live. Second, you can appoint one or more Substitute Decision-Makers (SDMs) who are legally authorised to make those decisions for you if you lose capacity.

What an ACD does not cover is financial and legal matters. If you want someone to manage your bank accounts, pay your bills, or sell property on your behalf if you lose capacity, that requires a separate document: an Enduring Power of Attorney. Many South Australians need both, and they serve completely different purposes.

The Witnessing Rules Are Strict

For an ACD to be legally valid in South Australia, it must be completed on the official form and signed before an authorised witness. Authorised witnesses include:

• A Justice of the Peace (JP)
• A lawyer or legal practitioner
• A police officer
• A registered health practitioner

The independence requirement is the part most people get wrong. Your witness cannot be any of the following:

• A person named as a beneficiary in your will
• A person you have appointed as an SDM in the ACD
• Your treating doctor or other healthcare practitioner who is directly involved in your care

This means your GP, the nurse who usually sees you, and your daughter who you plan to appoint as SDM are all disqualified. You need to find a JP or lawyer who has no personal interest in your affairs. Many councils, libraries, and police stations provide JP services at no charge.

The witness must be physically present when you sign. They are confirming that you appear to understand the document, that you are signing it voluntarily, and that you have the decision-making capacity to do so.

Who You Can Appoint as a Substitute Decision-Maker

You can appoint one or more SDMs in your ACD. An SDM is the person who makes health and lifestyle decisions on your behalf when you cannot. This is a significant responsibility and should not be given automatically to the eldest child or the nearest relative — it should go to the person who understands your values, can handle pressure from medical staff and other family members, and will genuinely follow your instructions.

You can also set out in the ACD the scope of your SDM's authority — for example, limiting them to healthcare decisions only while excluding accommodation decisions, or requiring that two SDMs agree before a major decision is made.

If you appoint multiple SDMs without specifying how disagreements are resolved, disputes can arise at exactly the moment you are most vulnerable. Be explicit in the document about decision-making hierarchy.

What Happens to the ACD at the Point of Death

This is one of the most important and most misunderstood points in South Australian law. An Advance Care Directive ceases to have any legal effect the moment you die. An SDM's authority to make health and lifestyle decisions ends instantly.

If family members attempt to continue making arrangements based on the ACD after death — for example, directing the hospital on the handling of remains — they are acting without legal authority. The executor named in your will takes over at the point of death. If there is no will, the estate lies dormant until an administrator is appointed by the Supreme Court.

This transition catches many families off guard, particularly when death follows a period of illness during which an SDM has been actively involved. Make sure both your SDM and your executor understand that their roles are distinct and sequential — not overlapping.

Common Mistakes to Avoid

Storing the ACD somewhere inaccessible. If your ACD cannot be found in an emergency, it cannot be used. Provide certified copies to your SDMs, your GP, and any hospital or facility where you receive regular care. Keep the original somewhere retrievable.

Not updating the ACD after major life changes. If your nominated SDM dies, moves overseas, or has a significant falling-out with you, update the document. A stale ACD with a deceased or unreachable SDM creates exactly the confusion it was meant to prevent.

Assuming the ACD covers everything. If you go into hospital and cannot communicate, your ACD governs your medical care. But it says nothing about who manages your finances, pays your rent, or accesses your superannuation. That requires an Enduring Power of Attorney running alongside it.

Not completing the official form. South Australia requires the official ACD form. Informal written statements, even clearly worded ones, do not carry the same legal force.

If You Do Not Have an ACD

If you lose decision-making capacity without an ACD, decisions about your health care will be made by the next person in the legally specified order of responsibility: your spouse or domestic partner, then your closest relative, then (in some cases) the South Australian Civil and Administrative Tribunal (SACAT). Those decision-makers may not know your preferences, and they may disagree with each other.

The ACD exists precisely to prevent that outcome. The official form is available through SA Health and can be completed at home before being signed before a witness.

How This Fits Into Estate Planning

An ACD is an instrument of planning, not grief. It works alongside your will and your Enduring Power of Attorney to cover three distinct periods: capacity (EPA for finances, ACD for health), incapacity (SDM acts under ACD, attorney acts under EPA), and death (executor acts under will).

South Australia's estate settlement process becomes significantly less fraught when these three documents exist, are current, and are accessible. If you are helping an ageing parent put their affairs in order — or working through your own — the ACD, EPA, and will belong on the same checklist.

The complete step-by-step guide to settling an estate in South Australia, including what happens to these documents after death and how the executor takes over, is covered in the South Australia Estate Settlement Guide.

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