An Empirical Investigation of Older Adults' and Professionals' Perspectives and Experiences of Advance Personal Planning
While many Australians may be familiar with Advance Care Planning, which relates to the process of thinking about and discussing future wishes regarding healthcare, the full range of instruments that form the broader legal process of Advance Personal Planning (APP) is less recognised. APP allows individuals to consider, discuss and record their values and preferences about future financial, health and personal matters in anticipation of a period of incapacity or death. This thesis presents an original study that investigates the experiences and perspectives of APP from three cohorts: people aged 65 years or older living in regional areas of New South Wales; lawyers working in regional areas of New South Wales; and professional key informants working within the fields of health, ageing and law. Their experiences are examined holistically, offering an informed perspective of existing barriers to engagement, factors affecting the quality of prepared instruments, and barriers that may prevent the successful implementation of an older person’s APP instruments during a period of incapacity in future. The deliberate combination of these cohorts, rather than the continued siloing of legal and health professionals, provides a unique contribution to understanding how APP processes are currently operating, and facilitates informed perspectives on opportunities for improvement. Findings are analysed through the integrated lens of Preventive Law and Therapeutic Jurisprudence, known as ‘theralaw’, and applied within the field of Elder Law. Integrating the respective foci of proactively preventing risks from occurring through communication and planning, and prioritising the wellbeing of older people when interacting with the legal system, produces a new appreciation for the benefits of APP. Perspectives of how the law supports, or fails to support, people as they age come to the fore, offering an examination of how APP can facilitate the realisation of autonomy and empowerment, while protecting the wellbeing and guarding against the vulnerability of older people. Recommendations are made at individual, professional and structural levels, offering informed suggestions for how APP processes can be improved. Reframing APP as an ongoing, routine, interprofessional and communication-based process between an older person, their support community and relevant professional advisors helps to promote the recognition of APP as a vital component of planning for the rest of life, rather than the end of life. The first three years of the graduate research student’s candidature were supported by the Australian Research Council Discovery Project Grant, ‘Taking Action: Increasing Advance Personal Planning by Community-Dwelling Older Adults’.
Networked Digital Library of Theses and Dissertations