Advance Care Planning (ACP)

Advance Care Planning (ACP) (PDF 853 KB) is the process of thinking about, discussing, and writing down your wishes about the type of medical care and treatment you want to receive in the future. In particular, towards the end of your life or when you are not able to make your own decisions. It's a good idea to think about ACP now, before you become seriously ill or injured. It's especially important to think about and discuss ACP if you have a terminal condition, are very frail, or have strong opinions about how and where you are treated at the end of your life.

A person creates an Advance Care Plan while they are still able to decide what they want in the future. An Advance Care Plan is done with the help of a health professional. This could be your GP, practice nurse, district nurse, medical social worker, cardiac, diabetes or respiratory specialist nurse, cancer nurse, hospice nurse or doctor.


My Advance Care Plan

You may wish to complete an Advance Care Plan to document your preferences and wishes for healthcare at the end of your life. An Advance Care Plan should be completed with the help of a health professional, and be the result of your thoughts and discussions with your family/whānau and loved ones.

A health professional can explain to you the details of medical treatments for the very ill or injured, and talk you through the benefits and risks of these treatments. If you wish, they can lodge your Advance Care Plan on your electronic record, to be shared with other clinicians if and when it's needed (for example, if you are seriously injured or unwell and in hospital).

It's very important that, if you make a plan, you give copies to your family/whanau and loved ones. You should also keep a copy somewhere that you and those who live with you know about, for example, with your enduring power of attorney document, will, and other important documents.

IMPORTANT - Your Advance Care Plan will only be used if you are not capable of making your own decisions and speaking for yourself.

Next steps

If you are thinking about ACP, you should take the following actions:

  1. Read the ACP guide (PDF 853 KB).
  2. Spend some time thinking about what values and beliefs around end-of-life issues are important to you, and consider discussing this with your family/whanau and loved ones. Specific issues to consider include:
    • Do you have a strong preference about where you die?
    • Do you have any specific religious beliefs or spiritual issues?
    • What concerns or fears do you have regarding the end of your life?
    • Do you wish for your organs and/or tissues to be donated, if possible, when you die?
  3. Print the Taranaki DHB Summary of my Advance Care Plan document and read through thoroughly.
  4. Fill out the Taranaki DHB Summary of my Advance Care Plan form (see below: Filling out my Advance Care Plan).
  5. Make an appointment to discuss ACP with your chosen health professional.

If you are making an appointment with your GP, let them know in advance that your appointment is for an ACP discussion. This will help to ensure that the appointment is long enough. It will also give your GP the chance to prepare before you arrive. Your ACP discussion with your GP might require more than one appointment. ACP is new to Taranaki, and not all general practice teams currently offer this service. Consider making a will and appointing an Enduring Power of Attorney (EPoA) .

Filling out my Advance Care Plan

A Taranaki DHB-specific Summary of my Advance Care Plan (PDF 167 KB) form has been developed. Feel free to print this form and complete it. Ideally use a black pen, this ensures it is clearer when copies are made.

You should complete pages one and two with your family / whānau, friend or EPoA. Pages three and four of the plan needs to be completed with the help of a health professional because they have to sign that you are competent to make these decisions. Competency is a legal term meaning that you can fully understand the decisions you are making. If you don’t get a health professional to sign the form, other doctors might question your ability to make these decisions.

Question 1 (Page 1): Asks for your NHI number. You may not know this number which is fine. Just ensure that your full name, date of birth and address is clearly written and correct.

Question 8 (Page 3): Here you can choose only one option. If none of the first four options apply to you and your wishes, choose the last option - option five. If you choose option five you will need to complete an advance directive with a health professional to help you write down your wishes in a way that others will understand when you can’t speak for yourself. The New Zealand Medical Association has templates (PDF 175 KB) for you to use. An advance directive is not easy to complete and may need more than one appointment to discuss.


I've finished my Advance Care Plan - now what?

You will need to sign your 'Summary of my Advance Care Plan' document when it is finished and you are happy with it. Once signed by both yourself and the health professional who has been assisting you it is important to retain the original copy yourself and consider giving copies to your EPoA, lawyer, family/whānau, friend or neighbour. You can even keep a copy in your fridge in a life tube (available from your local Age Concern for $4).

You need to keep a record of who has copies, so that you can change all of the copies in the future if you want.

Your health professional will need to email a copy of your ACP Plan to where it will be uploaded to your electronic file.


Making changes to your Advance Care Plan

If you wish to alter your 'Summary of my Advance Care Plan' document, you can simply print off another copy and complete the process above again. Be sure to destroy any old plans and ensure all copies with lawyers, family / whānau or friends are changed also.

ACP in the media

Click the links below to read the articles featured in our local media about ACP.


Contact us:

For all ACP queries in Taranaki, speak to the Taranaki DHB ACP facilitator Kym Noske:
Phone: (06) 753 6139 (extension 7083)
Mobile: 027 7777 852

Send completed Summary of Advance Care Plan to



Last updated: Tuesday, October 8, 2019

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