Advance Care Directive Australia: 2026 guide

What is an advance care directive and how do you make one?

An advance care directive is a document in which an adult with decision-making capacity records their values and preferences for future health care and, in most states, gives instructions about treatment that health professionals must follow. You use your own state or territory's form (New South Wales has no official form), sign it with the witnesses that state requires, and give copies to your doctor, your substitute decision-maker and any aged care home. It is only used if you can no longer make or communicate the decision yourself.

The short version

Advance care planning is the conversation. An advance care directive is the document that records it. A substitute decision-maker is the person who speaks for you when you cannot.
Every state and territory except New South Wales has an official form, and each one has a different name and witnessing rule (table below).
Not everything in a directive is legally binding. A clear refusal of treatment usually is. In the ACT and Tasmania, only refusals are binding.
Upload a copy to My Health Record and give copies to the GP, the substitute decision-maker and the aged care home.
Review it when health, living arrangements or the decision-maker change. This is general information, not legal or medical advice.

Advance care planning, advance care directives and decision-makers

Three terms get mixed up, so it helps to separate them:

Advance care planning is the process. NSW Health describes it as the person, their loved ones and health professionals talking about the person's values and the care they would want if they became seriously ill or injured and could not say what they want.
An advance care directive is the document that records the result. Depending on the state, it can record values and preferences, give specific instructions to accept or refuse treatments, and appoint a substitute decision-maker.
A substitute decision-maker is the person who makes health decisions when the person cannot. Victoria calls this a medical treatment decision maker, New South Wales, Western Australia and Tasmania an enduring guardian, and Queensland and the ACT an attorney.

A legally binding directive must be made while the person has decision-making capacity, and it only takes effect when they cannot make a health care decision themselves. While they can decide, they decide.

A directive is also different from a resuscitation plan (or goals of care form), which a doctor prepares, usually when someone's health is deteriorating. Advance Care Planning Australia explains that a resuscitation plan takes account of the person's wishes but also of what is medically realistic, so the two documents can differ.

Source: Advance Care Planning Australia: record your choices; NSW Health

The document in each state and territory

Advance Care Planning Australia notes that every state and territory has an official (statutory) form for appointing a substitute decision-maker, and every one except New South Wales has an official form for future health care choices. Use the form for the state where the person lives and will be cared for.

Advance care directives by state and territory (checked October 2026)
State or territory	Document for health care wishes	Substitute decision-maker	Signing and witnesses
Victoria	Advance Care Directive, with a values directive, an instructional directive (consent to or refuse specific treatment) or both	Medical treatment decision maker, appointed on a separate form	Two adult witnesses, one a registered medical practitioner; neither can be an appointed medical treatment decision maker. Cannot be witnessed remotely.
New South Wales	No legislated form. An Advance Care Directive can be written (or spoken); NSW Health publishes a form and booklet	Enduring guardian	Not required for the directive to be valid, but NSW Health strongly recommends a witness and/or a health professional sign it
Queensland	Advance Health Directive (Form 4). A Statement of Choices records wishes but is not legally binding	Attorney for health matters, named in the Advance Health Directive or an enduring power of attorney	A doctor or nurse practitioner assesses capacity and completes part of the form; then signed in front of a justice of the peace, commissioner for declarations, lawyer or notary public
Western Australia	Advance Health Directive. A Values and Preferences form is not a legal document	Enduring guardian, appointed in an Enduring Power of Guardianship	Two witnesses aged 18 or over, one authorised to witness statutory declarations
South Australia	Advance Care Directive (official form, on paper or online). It can also cover accommodation and personal matters	Substitute decision-maker(s) appointed in the same directive	One suitable witness, such as a health practitioner, justice of the peace, lawyer, social worker, police officer or teacher, who gives an information statement and checks understanding. Not a substitute decision-maker, anyone with an interest in the estate, the person's treating health practitioner, or someone in a position of authority where they live (including a nursing home)
Tasmania	Advance Care Directive, on the approved Tasmanian Department of Health form	Enduring guardian (must be registered with the Tasmanian Civil and Administrative Tribunal)	Must be witnessed; follow the instructions on the form
Australian Capital Territory	Health Direction (to refuse or stop treatment). A Statement of Choices records wishes but is not legally binding	Enduring attorney, appointed in an Enduring Power of Attorney	Follow the instructions on the form
Northern Territory	Advance Personal Plan, which can include an advance care statement and advance consent decisions	Decision-maker appointed in the same plan	One authorised witness, such as a justice of the peace, legal practitioner, health professional or police officer

Forms and instructions for every state are linked from Advance Care Planning Australia's state pages. Its National Advance Care Planning Advisory Service is on 1300 208 582 (weekdays, 8am to 4pm AEST) and can post a starter pack at no charge.

Source: Advance Care Planning Australia; Office of the Public Advocate (Victoria); NSW Health; Queensland Government; HealthyWA; SA Law Handbook; Office of the Public Guardian (Tasmania); Northern Territory Government

What is legally binding, and what is not

Advance Care Planning Australia is clear that not everything in a directive is legally binding:

A binding refusal (a clearly expressed refusal of a particular treatment) must be followed by everyone, including substitute decision-makers and health professionals.
Values and general wishes are not binding, but substitute decision-makers and doctors must take them into account.
Exceptions apply in some states, for example where an instruction is ambiguous, is not consistent with good medical practice, or the circumstances have changed in ways the person would not have anticipated.
Nobody can demand treatment that is clinically inappropriate. Doctors do not have to provide futile or non-beneficial treatment.

The states also differ on what counts. In the ACT and Tasmania, only instructions to refuse or withhold treatment are binding. In South Australia, a refusal is a binding provision and everything else is non-binding. In Victoria an instructional directive can consent to or refuse treatment, and Victoria's Office of the Public Advocate warns people to complete one only if they know the treatment they do or do not want, because health practitioners must follow it. An informal (common law) directive is not legally binding in Queensland.

If someone has strong views about particular treatments, Advance Care Planning Australia recommends completing the official directive for their state rather than an informal letter, so doctors are not left unsure whether it is binding.

Source: Advance Care Planning Australia: advance care planning and the law

What to include

A directive is most useful when it tells the people around you what matters, not just which treatments to avoid. Victoria's Office of the Public Advocate suggests starting with what you value, for example:

living in your own home
staying connected with family, friends and community
activities that make life worth living for you
how you weigh up managing pain, living longer, dignity and independence.

Depending on the state, a directive can then include:

specific instructions about treatments you would or would not want in particular situations. Western Australia's form, for example, covers medical, surgical, mental health and dental treatment, palliative care, and measures such as life support and resuscitation
outcomes you want to avoid, which South Australia's law expressly allows
where you would prefer to be cared for, and in South Australia, residential and accommodation arrangements
your substitute decision-maker, if your state appoints them in the same document
organ and tissue donation wishes, which South Australian and Western Australian directives can record.

A sensible order of steps

Think about what matters to you, ideally while you are well.
Talk to the people close to you and to the person you want as your decision-maker. Ask whether they are willing.
Talk to your GP about likely health problems and treatments. In Queensland a doctor or nurse practitioner must be involved anyway.
Complete your state's form, using its instructions.
Sign it with the right witnesses (see the table).
Share copies and upload it to My Health Record.

Source: Office of the Public Advocate (Victoria): making an advance care directive; HealthyWA; SA Law Handbook

Where to keep it: copies and My Health Record

A directive only helps if it can be found when needed. Keep the original somewhere safe, and give copies to your family, your substitute decision-maker, your GP and your local hospital. Keep a list of who has a copy, so you can replace them all if you change it.

My Health Record

The Australian Digital Health Agency says an advance care planning document can be added to My Health Record, where treating doctors can see it if, for example, you arrive at hospital unconscious, and where nurses in an aged care home can look at it if you become unable to communicate. To upload one:

Scan the signed document and save it as a PDF.
Sign in to My Health Record through myGov.
On the Documents tab, choose Advance Care Planning, then Add an Advance Care Planning Document.
Select the PDF, enter the date it was last updated and the name and number of the person who wrote it, then save.
Optionally, add up to two custodians: people who hold a copy and can be contacted for it.

The person's nominated and authorised representatives can also add the document. Help is available from the My Health Record helpline.

State options

Queensland: copies can be sent to the Statewide Office of Advance Care Planning, which adds complete documents to the person's Queensland Health record.
ACT: copies can go to the ACT Advance Care Planning Program or be uploaded to MyDHR.
Tasmania: the directive can be registered with the Tasmanian Civil and Administrative Tribunal (optional).
Northern Territory: the Advance Personal Plan can be registered with the Public Guardian and Trustee at no cost.
South Australia: there is no register, so certified copies to the decision-makers and the doctor matter.

Source: Australian Digital Health Agency: advance care planning; Advance Care Planning Australia: store and share your documents

Telling the aged care home

A directive does not have to exist before someone moves into an aged care home: South Australia's Office of the Public Advocate notes that a person can enter care without one. But it is one of the most useful documents to hand over on day one.

Under the strengthened Aged Care Quality Standards that apply from 1 November 2025, aged care providers must offer older people the option to take part in advance care planning, and use people's care plans to guide the care they deliver, including at the end of life. When a parent moves in:

Give the home a copy of the directive and of any appointment of a substitute decision-maker, and make sure the decision-maker's contact details are on file.
Ask how the home records the directive in the care plan, and how night staff and visiting doctors will know about it.
Ask whether the GP will complete a resuscitation plan or goals of care form, and check that it is consistent with the directive.
Check that the directive is uploaded to My Health Record.
Ask for the plan to be reviewed when health changes, not just once a year.

In South Australia, a person in a position of authority at the aged care home where someone lives cannot witness their advance care directive. If a resident wants to make a new directive after moving in, it is simplest to use a witness from outside the home. Our aged care tour checklist includes questions to ask about advance care planning before choosing a home.

Source: Aged Care Quality and Safety Commission: Standard 3, care and services; Office of the Public Advocate (SA)

Reviewing and changing it

A person can change or cancel their directive at any time while they have decision-making capacity. Advance Care Planning Australia suggests reviewing it whenever preferences or goals, living situation, substitute decision-maker or health change. Queensland recommends reviewing an advance health directive at least every 2 years, and HealthyWA suggests planning a review in 2 to 5 years.

How to change it depends on the state:

Victoria: make a new directive or complete a revocation form; a new directive replaces the old one.
New South Wales: make a new directive and replace every copy.
Queensland: revoke it in writing at any time and tell any attorneys; a later directive revokes an earlier one to the extent they are inconsistent.
Western Australia and Tasmania: a directive cannot be changed after it is signed, so revoke it and make a new one (in Tasmania, lodge a revocation if it was registered with the tribunal).
ACT: a new Health Direction automatically replaces the older one.
Northern Territory: write the change on the plan and have it witnessed, or make a new plan; the most recent plan applies.

After any change, tell the decision-maker, family and doctors, hand out the new version, and upload it to My Health Record as a new version.

Source: Advance Care Planning Australia: review your documents, and its state pages

If there is no directive

If a person cannot decide and has no directive, the law in each state sets out who doctors ask. In New South Wales this is the "person responsible": first an enduring guardian or tribunal-appointed guardian, then a spouse or de facto partner with an ongoing relationship, then an unpaid carer, then a close friend or relative. In Victoria, the medical treatment decision maker is the first available of an appointed decision maker, a VCAT guardian, then the spouse or partner, primary carer, oldest adult child, oldest parent and oldest adult sibling.

These lists are for health care decisions. Decisions about where someone lives follow different rules: see who decides about aged care when a parent can no longer decide.

Even without a directive, wishes can still be written down. Queensland's Statement of Choices Form B, the ACT's Statement of Choices (No Legal Capacity) and a Victorian form for recording what a family member understands to be the person's preferences and values all let the people closest to someone record what they know about the person's wishes.

Source: NSW Health: Making an Advance Care Directive; Office of the Public Advocate (Victoria); Advance Care Planning Australia

Questions families ask

Is an advance care directive the same as a will?

No. A will deals with property after death. An advance care directive is about health care during life, and is only used if the person cannot make or communicate a decision themselves. Most people benefit from having both, along with an enduring power of attorney for money.

Is an advance care directive legally binding?

Parts of it can be. Advance Care Planning Australia says a clearly expressed refusal of a treatment is usually binding and must be followed, although every state has exceptions, such as instructions that are unclear or circumstances the person did not foresee. General statements of values and preferences are not binding, but decision-makers and doctors must take them into account. In the ACT and Tasmania only instructions refusing treatment are binding.

Can an advance care directive refuse CPR or other life-prolonging treatment?

Yes. A person can record clear instructions refusing specific treatments, including resuscitation, for particular situations. But nobody can demand treatment that is clinically inappropriate, and in hospital a doctor may also complete a resuscitation plan, a clinical document that can differ from the directive if a treatment would not work or would cause harm. Talk it through with a GP when writing the instructions.

Will my advance care directive work in another state?

Often, but not always. Advance Care Planning Australia says valid statutory documents are often recognised elsewhere when their content fits the receiving state's law, but recognition depends on the type of document and what it says. To avoid delays, it recommends completing the official directive for the state where it will be used. Victoria recognises valid appointments of decision-makers made in other states.

Who should be my substitute decision-maker?

Someone you trust who is willing to take on the role, can make decisions in difficult and emotional circumstances, understands your needs, wishes, values and beliefs, and is easy to contact when a decision is needed. Talk to them about your wishes before you appoint them. In some states, such as New South Wales, you can also appoint a back-up.

Does someone need an advance care directive before moving into an aged care home?

No. South Australia's Office of the Public Advocate notes that a person can enter an aged care home without these documents. Under the strengthened Aged Care Quality Standards, aged care providers must offer older people the option to take part in advance care planning, so the home should raise it either way.

How do I add an advance care directive to My Health Record?

Scan the signed document as a PDF, sign in to My Health Record through myGov, open the Documents tab, choose Advance Care Planning and select Add an Advance Care Planning Document. You can also add up to two custodians who hold a copy. Nominated and authorised representatives can upload it for the person, and a new version needs to be added whenever the directive changes.

Sources

Last reviewed October 2026. We checked this guide against the official pages below. Rules and figures change, so check the source before you rely on a detail.

This is general information, not legal, financial or medical advice. Best Aged Care is a private placement service run by Boring Ventures Pty Ltd, not part of or acting for the Australian Government or My Aged Care. How we check our facts.