A new toolkit aims to support people living in residential aged care to express their wishes and preferences.

Lucy has dementia and lives in a residential aged care home with approximately 120 other people. She never made an Advance Care Directive to specify who should make important decisions for her if she becomes unable to do so herself. Lucy has no close family or friends to provide informal decision-making support. Her son and his family live interstate, and her daughter hasn’t seen her for years. With no one prepared to take on a formal decision-making role, the Public Advocate has been appointed as her guardian.

The Office of the Public Advocate has over 2,200 guardianship clients. When urgent decisions are needed, such as for health care or end-of-life care, staff need to understand what the person would want. Client wishes are followed when known and if it is safe to do so, but sufficient information is often lacking, and the client may no longer be able to express their wishes due to cognitive decline.

The Office of the Public Advocate has a project underway in partnership with Office for Ageing Well, to systematically record client wishes. This means that people like Lucy would have a document called "My Life My Wishes." This document informs any staff member from the Office of the Public Advocate about Lucy’s preferences when a decision urgently needs to be made. A staff training video will also be produced.

The project aims to learn how to better support older people living in residential aged care to express their wishes and exercise choice and control over the decisions in their lives. The tools and resources will be made publicly available to assist people in residential aged care and their supporters with decision-making.

The Office of the Public Advocate encourages everyone to make an Advance Care Directive to record future wishes and appoint a substitute decision-maker if needed. This ensures that their wishes and preferences are documented, and that they can nominate who they would like to make decisions when they can no longer do so.

The Substitute Decision-Maker toolkit, developed by Office of the Public Advocate and Office for Ageing Well, can assist substitute decision-makers appointed under an Advance Care Directive. The toolkit is available on the Office of the Public Advocate website.

The Supported Decision Making in Residential Aged Care project is supported by Office for Ageing Well.