How to Prepare an Advance Directive When a Parent Is Losing Capacity in WA
If your parent has been diagnosed with early-stage dementia, has had a stroke that's affecting their cognition, or is showing signs of declining capacity, you have a narrow window to get advance care documents signed — and it closes permanently. Once your parent loses the cognitive capacity to understand what they're signing, no advance health directive or enduring power of guardianship can be legally executed.
The fastest path: download a structured planning kit now, complete the AHD and EPG with your parent over one or two focused sessions, arrange two witnesses including one authorized witness, and get everything signed, scanned, and uploaded to My Health Record. From download to fully executed documents, this can be done in a single weekend if your parent is currently having clear days.
A solicitor appointment may take longer than your parent's capacity window. For a parent whose capacity window is measured in weeks or months, that timing is a gamble you don't need to take.
The Capacity Window: What You're Working With
Under the Guardianship and Administration Act 1990, both an advance health directive (AHD) and an enduring power of guardianship (EPG) require the person signing to have the cognitive capacity to:
- Understand the nature and effect of the document
- Freely and voluntarily choose to sign it
- Communicate their wishes (verbally, in writing, or through other means)
Capacity isn't all-or-nothing. A person with early-stage dementia may have clear periods where they can understand and sign legal documents, even if they have difficulty with complex financial decisions or short-term memory. The relevant question is whether your parent understands what the document does, can weigh the consequences of the treatment choices, and can communicate their wishes. That is distinct from whether they can manage complex financial affairs.
What this means practically: your parent may still have capacity to sign an AHD and EPG even if they've been told they shouldn't drive, manage their own medications, or live independently. But the window narrows with every week.
The Two Documents You Need (And Why Both Matter)
Western Australia splits end-of-life authority across two separate instruments. Your parent needs both:
Advance Health Directive (AHD)
Records your parent's specific treatment wishes — which medical interventions they consent to or refuse. Sits at the top of the WA hierarchy of treatment decision-makers. If the AHD covers the clinical scenario, it overrides everyone, including the person appointed as enduring guardian.
Why it matters right now: Without a valid AHD covering the treatment, health professionals follow the statutory hierarchy. After any guardian or enduring guardian with authority, it may move through a parent, spouse or de facto partner, adult child, sibling, primary unpaid caregiver, or another person with a close personal relationship. That may elevate an estranged relative or someone other than the person actually providing care.
Enduring Power of Guardianship (EPG)
Appoints someone (an "enduring guardian") to make personal, lifestyle, and medical decisions that the AHD doesn't cover. The EPG only activates when your parent loses capacity.
Why it matters right now: Without an EPG, if decisions need to be made that aren't covered by the AHD — where your parent lives, what support services they receive, consent to medical procedures the AHD doesn't address — the State Administrative Tribunal may need to appoint a guardian. It may not be the person your parent would have chosen.
Critical: the EPG must be signed while your parent still has capacity. Once capacity is lost, only the State Administrative Tribunal can appoint a guardian — your parent no longer gets to choose.
Step-by-Step: The Fastest Legal Path
Day 1: Preparation (you do this alone)
- Download the planning kit — read the Treatment Decision Worksheet, EPG appointment protocol, and witnessing requirements before sitting down with your parent
- Identify your authorized witnesses — you need two adult witnesses, at least one of whom qualifies under the Oaths, Affidavits and Statutory Declarations Act 2005. Currently registered doctors, pharmacists, JPs, nurses, and police officers qualify as authorized witnesses. A person whose listed registration or employment has ended, such as a retired doctor, does not qualify in that role. Your parent's GP is ideal as one witness. Book the second witness for the signing session.
- Schedule a focused session — pick a time when your parent is typically most alert. For many people with early cognitive decline, that's mid-morning after medication but before fatigue sets in.
- Book a GP appointment — if your parent has a regular GP, book a standard consultation. The GP can (a) discuss treatment preferences to inform Part 4, (b) witness the signing, and (c) note the AHD in your parent's clinical file. Three tasks, one appointment.
Day 2: Complete the Documents With Your Parent
AHD completion:
- Part 1 (personal details): straightforward — name, address, date of birth
- Part 4 (treatment decisions): this is where the Treatment Decision Worksheet matters. Work through specific clinical scenarios with your parent: "If you had a stroke and couldn't breathe on your own, would you want to be put on a ventilator?" "If you had a severe infection in the final stages of dementia, would you want antibiotics?" Translate their answers into the worksheet's clinically specific language
- Parts 2 and 3 (optional): if your parent doesn't want to complete the health conditions or values sections, cross them out clearly. Leaving them blank risks invalidity
- Part 6 (witnessing): completed during the signing session with witnesses
EPG completion:
- Your parent chooses who to appoint as enduring guardian and what functions to delegate
- The appointed guardian must sign an acceptance in the same document
- Both the appointment and acceptance need two independent witnesses, including one authorized witness
Day 3: Sign, Witness, Distribute
- Signing session with both witnesses present together, including one authorized witness. Your parent signs the AHD (Part 6) and EPG appointment; the appointed guardian signs the EPG acceptance in front of the witnesses. The witnesses sign their sections.
- GP witness + clinical file. If the GP is one of the witnesses, they can note the AHD in your parent's clinical record during the same visit.
- Scan and upload — black and white, 300 dpi, under 20 MB. Upload to My Health Record via myGov so treating health professionals can access it if needed.
- Distribute copies — give certified copies to the appointed enduring guardian, your parent's GP (if not already witnessed), and the aged care facility if your parent is in one.
- File the originals — secure location at home that the family knows about.
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What If Capacity Is Already Borderline?
If you're unsure whether your parent currently has the capacity to sign, take these steps:
- Talk to the GP first. A GP who knows your parent can assess whether they currently have sufficient capacity to understand and sign an AHD and EPG. This isn't a formal capacity assessment (that's more involved), but it provides an informed clinical opinion.
- Don't delay. If the GP says your parent has capacity today, move immediately. Capacity can fluctuate day to day with conditions like dementia — what's possible this week may not be possible next week.
- Document the process. Note the date, your parent's state of alertness during the session, and any witnesses' observations about their understanding. This evidence supports the document's validity if it's ever challenged.
- If the GP says capacity is already gone: the AHD and EPG window has closed. For guardianship, the State Administrative Tribunal may need to decide the issue or appoint a guardian.
What About the Financial Side?
An AHD and EPG cover personal, lifestyle, and medical decisions — not financial ones. If your parent also needs someone to manage their finances, bank accounts, and property, they need a separate enduring power of attorney (EPA) under a different part of the Guardianship and Administration Act 1990.
The EPA can be completed alongside the AHD and EPG, but it's a different document with different witnessing requirements. If your parent's capacity is declining, getting all three documents signed in the same session (or the same week) is the most practical approach.
Who This Is For
- Adult children whose parent has been diagnosed with early-stage dementia, Alzheimer's, or another progressive cognitive condition
- Families where a parent has had a stroke or brain injury and capacity may be temporary
- Anyone whose parent has been asked by an aged care facility to produce advance care documents before admission
- Siblings who need to coordinate quickly to get documents signed before a parent's next cognitive assessment
Who This Is NOT For
- Families where the parent has already lost capacity — the AHD and EPG window has closed; ask about a State Administrative Tribunal guardianship application
- Situations where siblings are in active conflict about who should be appointed guardian — a solicitor should mediate before documents are signed
- Parents who are cognitively healthy and planning proactively with no time pressure — you have more options and less urgency
Frequently Asked Questions
Can a person with dementia sign an advance health directive in WA?
Yes, if they currently have sufficient capacity to understand the nature and effect of the document. Early-stage dementia doesn't automatically mean someone lacks capacity. A GP familiar with your parent can assess whether they can understand what the AHD does, weigh the consequences of the choices, and freely choose to sign it. The relevant test is not whether they can manage complex decisions independently.
What happens if we don't get the documents signed in time?
Without a valid AHD covering the treatment, health professionals follow the statutory hierarchy, beginning with any guardian or enduring guardian with authority and then moving through a parent, spouse or de facto partner, adult child, sibling, primary unpaid caregiver, or another person with a close personal relationship. Without a valid EPG, the State Administrative Tribunal may need to appoint a guardian, and that guardian may not be the person your parent would have chosen.
Should we see a solicitor instead of using a kit?
If capacity is declining, waiting for a solicitor appointment is a significant risk. The legally safest approach for time-critical situations: complete the AHD and EPG now using a structured kit, get them properly witnessed and signed, then consult a solicitor afterwards if you want a review. A correctly executed document signed this week is more valuable than a solicitor-reviewed document that never gets signed because capacity was lost during the booking wait.
Can siblings share the enduring guardian role?
Yes — your parent can appoint multiple enduring guardians as joint enduring guardians, but they must act jointly and reach agreement. The form can also name substitute enduring guardians to take over if one or more cannot continue.
What if the aged care facility says our documents aren't valid?
Some aged care facilities have their own advance care planning forms and may push families to use them instead of (or in addition to) the statutory AHD. The facility forms are not legal instruments — they're internal care planning tools. Your parent's statutory AHD and EPG take legal precedence. If a facility questions validity, show them Part 6 (the witnessed signature) and confirm the document is uploaded to My Health Record.
The Western Australia Advance Directive & Living Will Kit is designed for exactly this scenario — a structured, same-day completion system when time is short. It includes the Treatment Decision Worksheet for clinically specific Part 4 language, the EPG appointment protocol, the authorized witness checklist, GP consultation prep, and the My Health Record upload workflow. Everything your parent needs signed, witnessed, and distributed before the window closes.
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