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Advance Care Planning

Planning for your future healthcare can help you and your family feel confident that your wishes will be heard, even if you are not able to express them yourself. This process is called Advance Care Planning.

Anything can happen! For example, you may be unable to make healthcare decisions if you:

  • get a sudden severe infection which makes you very confused 
  • are delirious following surgery and not in your right mind
  • suffer a serious head injury because of an accident and are unconscious.

Who will make health care decisions for you? How will they make decisions for you? Have you thought about what is most important to you?

What is Advance Care Planning?

Advance Care Planning (ACP)  includes conversations that help you and your Substitute Decision-Maker (SDM) prepare for future healthcare decisions. 

Advance Care Planning is not just about preparing for end-of-life. It is also planning for times when you are temporarily not able to make all your own decisions.

Why think about who is my Substitute Decision-Maker (SDM)?

Sometimes people cannot make their own decisions because they are too sick or unconscious (not awake). This could be during surgery, from an accident or due to an illness. You need an SDM during these times to make healthcare decisions for you. If you recover and become mentally capable again, you will make your own decisions. 

Think about who will be your SDM or SDMs. If you prefer to name someone specific to be your SDM, consider signing a Power of Attorney for Personal Care document. 

More information about a Power of Attorney is available at https://www.advancecareplanningontario.ca/substitue-decision-makers/attorney-for-personal-care.

In Ontario everyone automatically has an SDM or several SDM(s). This is set out in the Health Care Consent Act. In the chart below, the green SDMs are the automatic family member SDMs.

Ontario's Health Care Consent act 1996

For more information go to https://www.advancecareplanningontario.ca/substitue-decision-makers/who-is-my-sdm

Why talk to your SDM about what is important to you?

You cannot know what future healthcare decisions you may face, but you do know what quality of life means to you. You know what values and wishes would help you make health care decisions. Your SDM needs to know this too. 

What do I talk about with my SDM?

When you are ready, speak to your SDM about your values and wishes. Conversations about advance care planning can lead to a better quality of life for you. It can be very reassuring to know that you will receive the care you would like.

Take these steps:

  • Talk to your SDM while you are able to clearly think about your healthcare choices. It is important to start the conversation when you are feeling well. Tell your SDM about the values and wishes important to you.

  • Prepare your SDM because there may come a time when you are unable to make your own healthcare decisions.

  • Help your SDM learn how to make decisions for you if you are not able to make them yourself. Share the MGH Substitute Decision-Making Information Sheet with your SDM.

How does Advance Care Planning help your SDM and loved ones?

Advance care planning helps to prepare your SDM for their role. 

Talking about these plans with your family and friends can lessen their future distress and give them greater peace of mind. They will also know  what is important to you as they make decisions for you.

There are resources listed below to help you with Advance Care Planning.

Will healthcare providers talk to me about my wishes, values and beliefs?

Yes, as your condition changes, your healthcare providers may talk with you about your wishes, values and beliefs for your future care. 

They are not trying to scare you. They want to help you think about these things now and allow you time to share your wishes with your SDM in case you become incapable of telling them in the future. 

How is Advance Care Planning different than a Goals of Care conversation?

Advance Care Planning can be done anytime, even before an illness. It helps you prepare your SDM for unexpected illness or injury. 

Goals of care conversations happen when your are ill and specific care decisions need to be made. The healthcare team will speak with you and  your SDM about what is important to you for your care.

What resources can help me with Advance Care Planning?

Some good resources are:

Advanced Care Planning graph

From Advance Care Planning Ontario, available at https://www.advancecareplanningontario.ca/acp

Consent Information Sheet
Capacity Information Sheet
Substitute Decision-Making Information Sheet
Power of Attorney Information Sheet