If you are over 18 and able to make your own decisions, you can make an Advance Care Directive (ACD).

An Advance Care Directive is a legal document that can include decisions about your health care, accommodation, and personal affairs.

An ACD includes old Enduring Power of Guardianship, Medical Power of Attorney, and Anticipatory Direction documents.

It does not cover decisions about finances, property, or legal affairs.

For more information about making financial decisions, see our “Enduring Power of Attorney” Fact Sheet (PDF, 383.5 KB).

How to fill out an Advance Care Directive

When completing an Advance Care Directive you must use the official Advance Care Directive form.

You can get an Advance Care Directive form by:

In your ACD, you can appoint one or more substitute decision-makers (SDMs).

You can write down your wishes and instructions about your future, including end-of-life directions.

The more details you include about your wishes, the better equipped your SDM is to make the decision you would have wanted.

Your Advance Care Directive must then be signed by an authorised witness.

You should give certified copies to your SDMs and your doctor.

There is no ACD register.

If you are unable to physically sign your ACD, there are a few options available.

  • You can instruct someone else to sign on your behalf - this must take place with you and a witness present.
  • You can also 'mark' where your signature would have been if you can hold a pen (eg in your mouth).

There are different signing clauses that will need to be inserted into your ACD if you choose one of these options.

If you are unable to read or make a mark, a different clause will need to be inserted.

A Justice of the Peace will be able to help you with this.

More information is available in the:

You can also contact the Legal Services Commission for more information, on 1300 366 424.

How Substitute Decision-Makers can help

Substitute Decision-Makers should help if you are unable to make a particular decision for yourself.

In the Advance Care Directives Act 2013, being unable to make decisions is referred to as "impaired decision-making capacity".

Substitute Decision-Makers should also:

  • Ask you about your wishes and needs.
  • Strictly follow any medical refusals (these are legally binding).
  • Consider your past and present wishes, and your proper care and protection.
  • Try to make decisions as you would have made them (“stand in your shoes”).

See Making decisions for others for more information.

An ACD is a legal document which allows you to appoint one or more substitute decision-makers and write down your wishes and instructions about your future health, accommodation and lifestyle.

An ACD does not cover financial decisions.

Anyone over the age of 18 who can make their own decisions can make an ACD. A family member or friend cannot make this document on your behalf.

You do not need a Guardianship Order if you have an Advance Care Directive - a substitute decision-maker has the same authority as a guardian appointed by SACAT.

You can appoint a family member or friend.

You cannot appoint the Public Advocate, or a paid professional carer.

Even if you don't have someone to appoint as an SDM, you can still make an ACD and write down your wishes and instructions. The document is still valid, even if you don't appoint a substitute decision-maker.

An ACD needs to be witnessed. We recommend the following steps:

  1. Write down your wishes and instructions
  2. if you have appointed an SDM, they must sign to accept their appointment
  3. You must sign the ACD in front of your witness.

There is a list of authorised witnesses in the ACD kit, but we recommend using a JP if possible.

An ACD is active as soon as it is signed and witnessed.

The person who made the ACD should be able to make their own decisions for as long as possible - either alone, or with support.

If the person can't make a particular decision, substitute decision-makers should 'stand in their shoes' and make the decision the person would have made themselves.

South Australia will recognise other state's ACDs, as long as the instructions are legal in South Australia.

Yes - if the person still has decision-making capacity, making a new ACD would supercede the existing ACD.

If the person is unable to make their own decisions, someone could apply to SACAT for a substitute decision-maker to be revoked and a guardian to be appointed.


If the person has decision-making capacity, they could make a new ACD appointing someone else.

If there are other SDMs - and you are not required to act jointly - you can write to the person and the other SDMs, notifying them of your decision to renounce your role.

If you are the only SDM, and the person is unable to legally make a new document, you must make an application to SACAT for permission to renounce your appointment.


We recommend you give a certified copy to your substitute decision-makers, doctor, family and friends.

You should also take one with you if you have to go to hospital.