We’re reminded to check everything except what matters most.
Australia has perfected the art of the polite reminder – we’re regularly nudged to check what’s happening inside and out. At 50, the government sends a discreet birthday gift, and we return the favour with our poo. Cervical and breast screening follow the same formula: the right age, a simple tool, and the shared understanding that it’s just what responsible adults do.
Melissa Reader: When my husband, Mauro, was dying of cancer, we had no conversations and no guidance to prepare us.
Yet the reminders stop short of life’s final chapter – the most predictable stage we’ll ever face, certain to touch each of us in our own ageing and in those we love. For all our check-ups and scans, we’ve skipped the final nudge – to make a meaningful plan before crisis hits. It’s not just a missed opportunity; it’s a collective blindness. A moral failing.
The result is a profound misalignment between what people want, what families experience, and what the system delivers. Most Australians say they want to be cared for and to die in a home-like setting, surrounded by the people and comforts that matter most, yet half still die in hospital. We plan for everything else – careers, parenthood, retirement – but not for this. Too few conversations, too little meaningful planning for the one stage of life we all face.
We can’t claim ignorance. Most deaths occur among people over 75, and 70 per cent are predictable and can be planned for. Yet in those final months, up to 38 per cent receive low-value interventions they neither need nor want, costing $4 billion a year, according to KPMG. Money spent on escalation instead of dignity and comfort.
Loading
Advance care planning has been on the national agenda for two decades, backed by successive governments. Yet after millions in funding, 86 per cent of Australians still have no meaningful plan. The process is too clinical, too complex, and too far from how real families live and talk.
A recent federal study claimed a third of Australians have planned ahead – an encouraging headline, until you look closer. Just 19 per cent had only talked about it, and another 3 per cent had scribbled notes. Valuable, yes … but a chat isn’t a plan. It’s like calling it a retirement strategy because you once said you’d travel after work. What’s missing is a way to turn talk into something real – to capture values and preferences in a way that feels human, not bureaucratic.
In my own life, I saw what happens when there’s no plan. When my husband, Mauro, was dying of cancer, we had no conversations and no guidance to prepare us. He spent his last six months shuttling between wards and surgeries that changed nothing, except where and how he spent his final months. It cost him comfort, cost us time and cost the system dearly. He should have been at home, surrounded by love. Instead, he died in intensive care – clinical, impersonal and steeped in regret.
