Advance Care Directive South Australia

What the SA Advance Care Directive Replaced

South Australia took a different path from every other state. Under the Advance Care Directives Act 2013, a single document — the Advance Care Directive — replaced the old Enduring Power of Guardianship and the Medical Power of Attorney. Those instruments no longer exist in SA law.

The ACD is now the sole instrument for appointing someone to make personal, lifestyle, healthcare, and accommodation decisions on your parent's behalf. Through the ACD, the principal appoints "Substitute Decision-Makers" rather than guardians. These decision-makers can consent to medical treatment, choose residential care facilities, and make daily lifestyle choices — all from one document.

Financial decisions are still handled by a separate Enduring Power of Attorney under the Powers of Attorney and Agency Act 1984. So a complete setup in SA requires two documents: an ACD for personal and health decisions, and an EPOA for financial matters.

What You Can Include in an ACD

The ACD is more flexible than many families realise. It can include:

• Binding refusals of treatment — your parent can refuse specific medical procedures, and healthcare providers must honour those refusals
• Values and wishes — non-binding preferences about quality of life, religious practices, and end-of-life care
• Substitute Decision-Maker appointments — naming one or more people to make decisions when capacity is lost
• Conditions and restrictions — limiting what the decision-maker can do, or requiring consultation between multiple appointees

The binding refusal component is particularly significant. If your parent has strong views about life-sustaining treatment, ventilation, or artificial feeding, the ACD is where those instructions go. A valid binding refusal is legally binding on healthcare providers.

Witnessing Requirements

An ACD must be signed before one authorised witness. In SA, that means a Justice of the Peace, a lawyer, or a proclaimed police officer. The appointed Substitute Decision-Makers cannot witness the document.

The witness must certify that the principal appeared to have capacity and signed voluntarily. Unlike Victoria, which requires two witnesses with one being a medical practitioner, SA's single-witness requirement makes execution logistically simpler — but it also means there is less built-in protection against challenges.

If your parent's capacity is borderline — early-stage dementia, cognitive impairment, fluctuating lucidity — get a formal capacity assessment from their GP or a geriatrician before the signing session. That medical record protects the ACD against future challenges from other family members.

The Separate Financial EPOA

SA's Enduring Power of Attorney for financial matters works like most other states. The principal appoints a "donee" (SA's term for attorney) to manage bank accounts, pay bills, handle investments, and deal with property.

The EPOA must be witnessed by one authorised witness — a JP, lawyer, or proclaimed police officer. The donee cannot witness the document.

If the donee needs to sell or mortgage your parent's real estate, the EPOA must be registered with Land Services SA. Registration requires the original EPOA, a complete duplicate photocopy for comparison, and a fee of $204.00 (2026/2027 financial year).

When Capacity Is Already Lost

If your parent cannot understand the nature and consequences of signing, it is too late for both an ACD and an EPOA. The fallback is applying to the South Australian Civil and Administrative Tribunal (SACAT) for guardianship and administration orders.

SACAT applications are free. You will need a medical or psychological report confirming the cognitive impairment. SACAT follows the "least restrictive" principle — it only makes orders when informal arrangements are not working and there is an active decision that needs legal authority behind it.

If SACAT appoints the Public Trustee SA to manage your parent's finances, their capital commission runs up to 4.4% on managed assets. Setting up the EPOA before capacity is lost avoids that ongoing cost entirely.

Getting Both Documents Done

The practical approach in South Australia is to complete both documents in the same signing session — ACD and EPOA back to back, with the same authorised witness. This minimises the risk of a capacity change between sessions and keeps the paperwork aligned.

For the complete SA process — including witnessing checklists, SACAT application steps, and institution registration guidance — see our Enduring Power of Attorney and Guardianship in Australia guide.

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