Advance Care Planning

Advance Care Planning

Advance Care Planning is a process of:

  • thinking about your values, beliefs, and wishes for future health and personal care, and
  • sharing them with the people you trust.

It can include choosing who would make care decisions for you if you cannot.

Advance Care Planning (ACP) can help you get the care that’s right for you, even if you’re unable to speak for yourself.

You might have done some other types of life planning already – such as preparing a will, saving for retirement or appointing a guardian for your child. Advance Care Planning is another type of life planning… it’s planning ahead for your future health and personal care.

Advance Care Planning is as easy as Think, Talk, Plan

We’ll take you through all the information you’ll need to complete the Think, Talk and Plan steps of Advance Care Planning. If you don’t complete all the steps at once, don’t worry. Through the process, you’ll consider some big questions, so take your time and come back to it as often as you need.

Even if you’ve already done Advance Care Planning, you should review it periodically, especially after any major life event or change in your health.

Already familiar with the Advance Care Planning Process?

Check out the resources on our Advance Care Planning Resources page.

Why, Who and When of Advance Care Planning

To take a look at the big picture of Advance Care Planning, take a look at the Why, Who and When of Advance Care Planning. It’s a great way to start getting yourself into the Advance Care Planning mindset.

Steps of Advance Care Planning

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Think: What matters most to you?

Just like other major decisions in your life, your future health and personal care decisions will depend on what matters most to you – your values and beliefs. The last thing you want is to be thinking about it for the first time when you need to make an urgent decision. It can take time to truly understand your values and beliefs in a way you can explain to others.

That’s why it’s so important not to rush the “Think” step.

You should think about:

  • your personal values: the things that are important to you in life and wish to continue with even if you became seriously ill.
  • your personal beliefs: the spiritual or cultural beliefs or practices that are important to you, or that would influence your health or personal care decisions.
  • your personal wishes: where you want to be cared for and things you would like to have with you.

These all inform your future care decisions.

  • what makes a good day?
  • what gives you joy and purpose, or a sense of achievement?
  • what cultural, religious or spiritual beliefs are important to you?
  • how do you prefer to make important decisions?
  • what concerns you when you think about your future health?
  • what are your thoughts about organ donation?

What else you should think about depends on what stage of life you’re in.

  • What is important to you to maintain your quality of life?
    For example: hobbies, religious/spiritual beliefs, preferences for food/music/art, specific routine for personal care.
  • What abilities can you not imagine living without?
  • What abilities would you be willing to give up to live longer?
    By abilities we mean things like getting dressed, going to the toilet, eating and drinking, walking, hearing, seeing, talking with family and friends, driving and managing your finances.

You may also want to think about what kinds of treatment you might want or not want in the future. You don’t have to think about this, but if you have a serious illness you might find this a valuable step.

Click here for resources to help you think about what matters most.

Think: Who could make health-care decisions for you if you can’t?

If you can understand information about your care options and communicate your wishes, you will be asked to make decisions about your health care. However, if you are too sick to make this decision and speak for yourself, you will need someone to speak to your health-care providers and make decisions for you.

You also have a right to receive support in your decision making from the people you trust to help you:

  • understand the information provided, and
  • communicate your wishes.

If you have to make a decision but have trouble understanding the information, even with support, someone else will be asked to make that decision for you.

  • To learn about what makes a good substitute decision maker, and the options in B.C. visit our page on substitute decision makers.
  • Being unable to speak for yourself is a common situation. It may be temporary or permanent, or change from day to day. To learn more, visit Capability and Informed Consent.
Think

Talk: Discuss your thoughts with the people you trust

After you’ve done your thinking, don’t keep those thoughts to yourself! It’s vital that the people who may be involved in your future care know about what matters most to you and who you want to speak for you if you can’t.

Whoever you’ve chosen, they need to know your values, beliefs and wishes before they can follow them. That’s why starting a conversation about Advance Care Planning is so important.

Deciding who to share your thoughts with is up to you. The most important thing is to begin. Make time and create a comfortable environment to talk with the people you trust.

“I’m not sick right now, but I want to share with you what matters most to me, and how I want to be cared for in the future.”

You could also talk about something you have seen in the news or on TV, or recent experiences of family or friends:

“I was thinking about what happened to John when he was sick. I wouldn’t want that. I would want…”

  • your thoughts about what matters most to you and what your goals are.
  • your biggest fears and worries about your future health.
  • who will make health-care decisions for you if you cannot make these decisions. Make sure your other family members know how you would like them to support the person you have chosen.

Things may come up in these conversations that lead to more thinking.

This is ok, you can move back and forth between the steps. Advance Care Planning isn’t a one-and-done process; revisiting earlier steps is a natural and common part of the process.

Talk: Discuss your thoughts with your health-care provider

Just like with your family and friends, it’s important that your health-care provider knows about what matters most to you. This will help them ensure that the care you receive aligns with your wishes. You should also tell them who you have chosen as your substitute decision maker.

In this conversation you can also find out more information about your health and future health. This will help you when you are thinking about what matters most to you.

  1. Book a time with your health-care provider to understand your health conditions. Consider involving your substitute decision maker in this conversation. It will help them if they ever need to make decisions for you
  2. Take your time to reflect on their answers. What you learn from them will help you think about what matters most and who you would want to speak for you if you cannot.
  3. Book a time with your health-care providers to share what they need to know about you, including:
    • What matters most to you – your values, beliefs and wishes for health and personal care. This will help them consider the care options that are aligned with your preferences.
    • Who can speak for you when you can’t of making health-care decisions for yourself. In other words, who are your substitute decision makers?

The conversation with your health-care provider may be different if you are currently healthy, or if you are living with a serious illness. If you are living with a serious illness, here’s some more information on what that conversation can include.

Talking with your health-care providers is an ongoing process.

Plan: Record your wishes

It may be a long time between talking to people and the time they need to make decisions for you. Memories fade, so write it down. It will remind people what you said, help guide decision making, and provide evidence of your wishes if there is a disagreement. Even if you can make decisions, it will help you remember what you thought about.

  1.  A record of your values, beliefs and wishes for health and personal care
  2. Names and contact information for people on your Temporary Substitute Decision Maker List. You can include notes on people who would not be eligible on your Temporary Substitute Decision Maker List and why.
  3. Any legal documents you have made:
    1. Representation Agreement
    2. Advance Directive
  4. Any medical orders you have:
    1. MOST Form
    2. No CPR Form

Plan: Share your plan

Share a copy of your Advance Care Plan with the people you trust and your health-care providers. Store it in a safe, easily accessible place. First responders know to check on or near your fridge. Bring it with you if you go to hospital.

Remember: as long as you are able to understand and communicate, you will be asked to make your own health-care decisions

plan

Review

Advance Care Planning is not a one-time event.

  • Your thoughts may change, so it’s important to update your Advance Care Plan so it stays accurate.
  • You can change your advance care plan at any time.
  • If you have made any legal documents there may be specific requirements to change them.

If you update your plan, don’t forget to share it with the people you previously shared it with.

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Production of this document has been made possible thanks to funding from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.