Advance Personal Plans
An Advance Personal Plan (sometimes referred to as an APP) is a legal document. Created under the Advance Personal Planning Act 2013 it allows a person to:
- record their wishes about future decisions
- make decisions about their future health care
- choose someone to make decisions for them if needed.
It does not replace a Will as it is only valid while the person is alive.
Why make an Advance Personal Plan
An Advance Personal Plan is important because it helps a person stay in control, as it plans for the future, it lets them say what they want and who they trust to decide for them. The benefits of an Advance Personal Plan include:
- Ensuring the person's healthcare preferences are respected. Any decisions they document are legally binding.
- Helping doctors and decision makers understand the person's choices.
- Empowering the person to decide what happens to them, even if they are unable to communicate.
- Providing clear instructions which can ease the emotional burden on the person's family.
- Prompting conversations about the person's values and future choices.
- Nominate a decision maker(s) on their behalf in case they lose capacity in the future.
Who should have an Advance Personal Plan
It is important for everyone over the age of 18 with decision-making capacity to have an Advance Personal Plan.
Advance Personal Plans are not just for people reaching end of life. They are useful in many situations, like when someone becomes unwell for a short time or has an accident and cannot make decisions for themselves.
Making an Advance Personal Plan while healthy, allows time to:
- think carefully about any future decisions
- talk to family, friends, or decision makers
- get advice if needed.
An Advance Personal Plan is especially helpful for people who:
- have a chronic or mental health condition
- have a condition that affects memory or thinking
- manage multiple health issues
- have young children or people that depend on them
- own a lot of property or money
- are getting older or nearing end of life
- want to make sure that health choices are followed.
If someone cannot understand or communicate their wishes, they cannot make an Advance Personal Plan. However, they still can be supported to record their healthcare preferences in a Values and preferences statement.
This type of document is not legally binding, but doctors and family should still look at it and use it to guide health care decisions.
When there is no Advance Personal Plan
If a person has lost the ability to make their own decisions and does not have an Advance Personal Plan:
- health decisions will be made by their Health Care Decision Maker (usually a close family member or friend)
- decisions about where they live, their finances, or support needs must be made by a legally appointed guardian.
Adult guardians are appointed by the Northern Territory Civil and Administrative Tribunal.
Find out more about making heath decisions and guardianship.
When an Advance Personal Plan can be used
An Advance Personal Plan can only be used when the person has impaired decision-making capacity.
This could be:
- Temporary, such as during a short illness or after an accident. The Advance Personal Plan can be used while the person is unwell and paused when they have recovered.
- Permanent, such as after a serious injury. In this case, the Advance Personal Plan stays in place unless the person's capacity improves/changes.
Before using an Advance Personal Plan, a doctor or health professional should check if the person still has the ability to make decisions.
Decision-making capacity
Every adult is presumed capable of making their own decisions unless proven otherwise. A person may have impaired decision-making capacity if they have difficulty:
- understanding and remembering information relevant to the decision
- weighing up this information to make the decision
- communicating their decisions in some way
- understanding the effect of the decision.
Decision making capacity is:
DOMAIN SPECIFIC - a person may be able to make health care decisions but not financial decisions.
DECISION SPECIFIC - a person may be able to make some health care decisions but not others (for example they may be able to consent to a blood test but not to a course of cancer treatment).
TIME SPECIFIC - a person's capacity may fluctuate (for example they might have better cognition at certain times of the day or regain capacity at a later date).
It may be quite clear that a person no longer has the ability to make decisions. However, there may be times where the person's ability to make decisions is unclear.
In these cases, a doctor or health professional should be asked to assess the person. They can:
- confirm if the person has impaired capacity
- say which types of decisions the person can or cannot make.
Decision-making capacity is regained
Sometimes a person's health improves, and they might regain the ability to make some or all of their own decisions.
If the person has regained capacity:
- the Advance Personal Plan no longer applies, and
- the person takes back the right to make their own choices.
If there is a disagreement about whether the person can make decisions, a request can be made to the Northern Territory Civil and Administrative Tribunal. The Tribunal will look at the facts and decide what decisions the person can or cannot make.