Background Advanced care planning (ACP), the practice of discussing and documenting patient preferences, goals and values and aligning this with appropriate medical care is a focus point in Australia. This is considered of particular importance amongst those with palliative care diagnoses and the older population.

Aims To compare completion rates of ACP documentation between older patients (age greater than 65 years) admitted to a palliative care unit (PCU) and geriatric unit (GU). The secondary aim was to assess the factors influencing completion of ACP.

Methods A retrospective chart analysis of electronic records was conducted, examining 50 consecutive charts each from a PCU and a GU, spanning July to August 2021. The data was analysed using both descriptive statistics and inferential statistics including Pearson’s chi-squared test, Fisher’s exact test, the two-sample t-test and the Mann Whitney U test.

Results 100% of PCU and 96% of GU inpatients had at least one form of ACP documentation. All PCU inpatients had an acute resuscitation plan by discharge compared with 64% in the GU cohort. 74% of PCU and 70% of GU patients had an enduring power of attorney. PCU inpatients were more likely to have an AHD than GU inpatients (26% vs 2%; p = < 0.001). Within the GU cohort, factors associated with ARP completion were reason for admission (< 0.001) and location prior to ward admission (< 0.001). Dementia was not associated with completion of ACP.

Conclusion There were high rates of ACP in the study cohort. Despite this, improvements could be made, particularly for documents outlining values, preferences, and treatment decisions. Opportunistic ACP may be most beneficial in the GU population compared with a proactive approach for a palliative care population.