It is one of the most important conversations a family can have, and one of the most often put off. An advance care planning conversation is simply a chance to talk about what matters to you, or to someone you love, if serious illness or injury meant you could no longer speak for yourself. It needn't be grim or formal. Done gently, it can bring families closer and remove a great deal of uncertainty later on.
Here are practical ways to begin, what to cover, and how to keep the conversation kind.
Why an advance care planning conversation matters
Over many years in aged care, we have seen the difference these conversations make. When families know a person's future health care wishes, decisions in hospital or at the end of life tend to feel clearer and calmer. When they don't, loved ones can be left guessing, sometimes disagreeing, at the hardest possible moment.
Talking early allows you to:
- Explain your values and what a good quality of life means to you
- Choose who you trust to make decisions if you can't
- Lift the burden of guessing from your family
- Prepare to complete an Advance Care Directive with confidence
Advance care planning is a key part of end of life planning in Australia, but it isn't only for people who are elderly or unwell. Anyone over 18 can benefit from thinking ahead.
Choosing the right time and place
There is rarely a perfect moment, but some moments are better than others. Look for a relaxed, private setting where nobody is rushed: a quiet afternoon at home, a walk together, or a long drive. Try to avoid times of crisis or high emotion if you can.
Natural openings can help too. A birthday, a friend's illness, a news story or a recent medical appointment can all provide a gentle way in.
Conversation starters that work
The first sentence is often the hardest. Here are some openings families have found helpful:
- "I've been thinking about what I'd want if I got really sick. Could I talk it through with you?"
- "When Grandma was in hospital, I realised we never knew what she wanted. I don't want that for us."
- "I'd feel much better knowing I could do what you'd want if something happened. Can we talk about it?"
- "My doctor suggested I think about an Advance Care Directive. Would you help me?"
If you are raising the topic with a parent, framing it around your wish to honour their choices, rather than any concern about their health, usually helps. Our article on questions to ask ageing parents offers more ideas.
What to talk about
You don't need to cover everything at once. These themes give the conversation some shape.
Values and what matters most
- What makes life meaningful for you?
- What would you find unacceptable in terms of quality of life?
- Are there cultural, spiritual or personal beliefs that should guide your care?
Future health care wishes
- Are there treatments you would want, or not want, in certain situations?
- Where would you prefer to be cared for, and where would you prefer to die if you had a choice?
- What would comfort look like for you towards the end of life?
Who will speak for you
- Who would you trust to make medical decisions for you if you couldn't?
- Do they know your wishes, and are they willing to take on the role?
Our advance care planning page explains substitute decision-makers and how Advance Care Directives record these choices.
Some families find it easier with a calm, experienced guide in the room. Our 90-minute guided family conversation, available by telehealth Australia-wide, ends with your state or territory Advance Care Directive form completed and ready to be witnessed. Book an Advance Care Planning Consultation
Handling difficult emotions and disagreement
It is natural for these conversations to stir up feelings. A parent may say, "I don't want to talk about dying." A sibling might become upset or disagree with a choice. That is all right.
Some gentle approaches:
- Listen more than you speak. The aim is to understand, not to persuade.
- Acknowledge feelings. "I know this is hard to think about" goes a long way.
- Focus on values. Explaining why someone wants something often eases disagreement.
- Pause if needed. It is fine to stop and come back to it another day.
It can also help to involve a neutral third party. A GP, a trusted friend or an experienced facilitator can keep the conversation on track, answer general questions and make sure every voice is heard, especially when siblings live in different cities and are joining by phone or video.
Remember that the wishes belong to the person making the plan. Family members may have different views, but the goal is to honour that person's choices.
Turning the conversation into a plan
Talking is the foundation, but writing your wishes down gives them weight. Once you have had your advance care planning conversation, the next steps usually include:
- Completing the official Advance Care Directive form for your state or territory
- Having it witnessed according to the rules where you live
- Giving copies to your substitute decision-makers, your GP and your family
- Reviewing it after major health or life changes
Each state and territory has its own form and requirements. In South Australia, the Advance Care Directive was introduced under the Advance Care Directives Act 2013 (SA) and must be witnessed by a suitable witness. If you live in Adelaide or elsewhere in SA, our Adelaide advance care planning page has local information.
Keep in mind that an Advance Care Directive covers health and personal decisions, not money. Financial matters are usually handled through an Enduring Power of Attorney, which is worth discussing with a solicitor. Our article on what happens if you lose capacity explains why both matter.
Where to from here
Starting an advance care planning conversation is a gift to the people you love. It doesn't have to be perfect, and it doesn't have to happen all at once. What matters is that it begins.
Care & Legacy Advisors was founded by Jane Rooke, a Registered Nurse with 20 years in aged care senior management, who has guided hundreds of families through these conversations. We are based in Adelaide, South Australia, and offer telehealth consultations nationally. If you prefer to start at your own pace, the self-guided Advance Care Planning Workbook is a helpful companion to your state's official form, and our estate readiness support can help you organise everything else. Care & Legacy Advisors are happy to go through the process alongside you.