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Advance Care Directive vs Power of Attorney South Australia: Which Do You Need?

They Cover Completely Different Territory

South Australia draws a hard line between healthcare decisions and financial decisions — and if you lose capacity, you need separate legal documents for each.

An Advance Care Directive (ACD) covers healthcare, personal, lifestyle, and accommodation decisions. It's governed by the Advance Care Directives Act 2013.

An Enduring Power of Attorney (EPA) covers financial, business, and legal property decisions. It's governed by the Powers of Attorney and Agency Act 1984.

Neither document can cross into the other's territory. You can't use your ACD to authorise someone to sell your house, and you can't use your EPA to consent to a medical procedure. South Australia is strict about this separation — it's built into the legislation, not just a convention.

What the ACD Actually Covers

Your ACD lets you:

  • Record binding refusals of specific medical treatments (CPR, ventilation, blood transfusions, chemotherapy)
  • Document non-binding preferences about your care, lifestyle, and living arrangements
  • Appoint up to four Substitute Decision-Makers (SDMs) who can make healthcare and personal decisions when you lose capacity
  • Express preferences about organ donation, palliative care, and end-of-life comfort measures

Your SDM's authority is limited to the ACD's scope. They can consent to or refuse medical treatment, choose between aged care facilities, and make day-to-day personal care decisions. They cannot sign a contract, access your bank account, or deal with your property.

What the EPA Actually Covers

Your EPA lets you appoint an attorney (or multiple attorneys) to handle:

  • Banking — accessing accounts, paying bills, managing investments
  • Property — buying, selling, or mortgaging real estate
  • Business affairs — running a business, signing contracts
  • Tax and government obligations — lodging returns, dealing with Centrelink

The attorney's authority can be general (covering all financial matters) or limited to specific tasks. If your attorney needs to deal with real property, the EPA must be registered with Land Services SA.

Unlike the ACD, an EPA can operate while you still have capacity — you can grant immediate authority so your attorney can act right away, or you can make it conditional on loss of capacity.

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Why You Need Both

The gap between these documents creates real problems if you only have one.

ACD only, no EPA: You get sick, lose capacity, and enter hospital. Your SDM can make medical decisions and choose an aged care facility — but nobody can pay your mortgage, manage your bank accounts, or keep your bills current. Your family would need to apply to SACAT for an administration order, which takes time, costs money, and puts a government-appointed administrator in charge of your finances.

EPA only, no ACD: You lose capacity. Your attorney manages your money, but they have zero legal authority to consent to medical treatment, choose between hospitals, or make decisions about your daily care. The system falls back to the statutory "Person Responsible" hierarchy — which might mean your treating doctor consults your spouse, your adult child, or even a care facility manager. You don't get to choose.

Both documents together: Your SDM handles your healthcare and personal decisions. Your attorney handles your finances. Between them, every decision that needs making is covered by someone you've chosen and briefed.

How They Work Together in Practice

Here's a common scenario: you have dementia that progresses to the point where you can no longer manage your own affairs.

Your EPA attorney steps in to pay your aged care fees, manage your pension, maintain your insurance, and handle the financial side of your care. Meanwhile, your ACD's SDM works with the medical team to consent to treatments, refuse interventions you've documented rejecting, and ensure your accommodation and personal care preferences are followed.

If you've appointed the same person to both roles — which is allowed and common — they wear two different legal hats. When they sign a consent form for surgery, they're acting as your SDM under the ACD. When they pay the hospital bill, they're acting as your attorney under the EPA. The distinction matters because their obligations and the dispute resolution mechanisms differ under each Act.

The Key Differences at a Glance

Feature Advance Care Directive Enduring Power of Attorney
Governing law Advance Care Directives Act 2013 Powers of Attorney and Agency Act 1984
Scope Healthcare, personal, lifestyle, accommodation Financial, property, business, legal
Decision-maker title Substitute Decision-Maker (SDM) Attorney
Maximum appointees 4 SDMs (expandable with supplementary form) No statutory limit
When it activates Only when you lose capacity Can operate immediately or on loss of capacity
Witnessing Authorised professional witness required Standard witnessing requirements
Registration No state registry Must register with Land Services SA if dealing with real property
Revocation Execute a new ACD or formal cancellation Formal revocation instrument
Ceases at death Yes Yes

Getting Both Done

The practical advice is simple: do both documents at the same time. You're already having the conversations about who you trust and what your preferences are — extending that to financial matters while you're in planning mode saves a separate round of appointments and paperwork.

Our South Australia Advance Directive & Living Will Kit covers the ACD side comprehensively — the clinically precise drafting language, the SDM appointment process, and the strict signing protocol — and shows you exactly how the ACD and EPA complement each other so nothing falls through the gap.

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