Many people know that Advance Care Planning is important, but find it difficult to begin. By reading about this topic, you’re already getting started. This page explains what Advance Care Planning is, why it matters, and outlines the key steps involved.
What is Advance Care Planning?
Advance Care Planning is a process that helps you think about and communicate your wishes for medical care in case you can’t make decisions for yourself. It can guide the people who may need to make decisions on your behalf.
Advance Care Planning involves writing down directions for your care in a legal document called an Advance Directive. This document can have different names depending on where you live. Your plan will also identify a Substitute Decision-Maker who can refer to your directive in medical situations where you can’t make decisions yourself.
Why Advance Care Planning matters
Advance Care Planning is not only about end-of-life. It can also help in any situation where you are unable to communicate your wishes, either temporarily or permanently.
For example:
- serious illness
- cognitive decline or dementia
- sudden injury or unconsciousness
In these situations, your Advance Directive and your Substitute Decision-Maker help ensure your care reflects your values and preferences.
How Advance Care Planning works
Advance Care Planning involves thinking through possible medical situations and how you would want care decisions to be made. Documenting your thinking helps ensure your wishes are understood by loved ones and health care providers if you’re unable to speak for yourself, especially in urgent situations
Your wishes can be communicated in a legal document called an Advance Directive. It outlines the types of care you would accept or decline, and may include guidance related to specific hypothetical scenarios. It also identifies a Substitute Decision-Maker – the person who would make decisions on your behalf, based on your values and preferences, if you become incapable.
Understanding scenarios
Many Advance Care Plans include example scenarios. These are not predictions about your future health, but rather hypothetical situations that help you reflect on what quality of life means to you and what kinds of care you would want.
Example Scenario:
You suffer a sudden stroke. This causes permanent problems with thinking, memory, speech, mobility and swallowing. Doctors say you will need assistance with basic self-care like feeding, bathing, and toileting, and that you will need to be tube-fed for the rest of your life. Would you accept this quality of life for yourself?
Options may include:
- yes
- yes, on a trial basis (describe what “trial basis” would look like for you)
- no
- I am uncertain (describe your thinking)
Example Scenario:
You have advanced dementia. You can no longer feed or toilet yourself, but you are not in pain. You are presented with feeding options. Would you want to be spoon-fed, or tube-fed?
Options may include:
- spoon-fed only (no tube feeding)
- either spoon-fed or tube-fed
- I don’t want to be fed
- I am uncertain (describe your thinking)
Find more example scenarios in Dying With Dignity Canada’s Advance Care Planning Kit.
Key parts of an Advance Care Plan
Most plans capture:
- your values and priorities
- your wishes for future health care
- your choice of Substitute Decision-Maker
Your plan can change over time
An Advance Care Plan is not something you complete once and then forget about. Your wishes may change over time as your health, priorities, or circumstances evolve.
When you’re ready to get started, you can consider these practical steps.