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Advance Care Planning

Advance care planning involves thinking about and writing down your wishes and instructions for your health.  It includes choosing the people you want to make decisions for you, if you cannot speak for yourself.

Think, Talk, Plan

You can make an advance care plan at any time. The best time to make one is when you are healthy enough to make these decisions. However, many people start thinking about advance care planning when they are diagnosed with cancer or another illness.

Think about your values and beliefs

  • What do you want and what is important to you? 
  • What kind of events and activities make you happy?
  • Are there spiritual or cultural beliefs that are important to you?
  • What do you fear the most about nearing the end of life?
  • What are your end-of-life wishes? For example, where would you like to be? Who would you like with you?

Think about who could make decisions for you

  • If you are unable to make decisions for yourself (you are sick or injured), someone else needs to make decisions for you. This person is called a Substitute Decision Maker.
  • You choose your Substitute Decision Maker by filling out an Enhanced (section 9) Representation Agreement .  This is a legal form. You do not need a notary or lawyer to fill out this form.  You can do this yourself.
  • A Substitute Decision Maker must be at least 19 years old and has agreed to be your decision maker.
  • If you do not choose a Substitute Decision Maker, a Temporary Substitute Decision Maker is chosen for you.  This person is chosen from a list. You cannot change the order of this list.  It is defined by law. Your health care team will move down the list until they find someone who is willing and able to make decisions for you.
    • The order of the list is: Spouse (including common-law), child, parent, sibling, grandparent, grandchild, anyone related to you by birth or adoption, close friend, person related to your by marriage, public guardian or trustee.
  • Complete this list of your temporary substitute decision makers
  • Guide for substitute decision makers

Think about what type of care you want

  • An Advance Directive deals with a specific treatment. For example, an advance directive tells your health care team if you want to be put on a respirator to help you breathe. 
  • Think about your goals, preferences and wishes for care.
  • Then, talk to your health care team about:
    • What your health will likely be in the future
    • Treatment options you might need
  • Once you have all of this information, you can write an advance directive.
  • If you do not have an Advance Directive, your Substitute Decision Maker will make these decisions for you if you are unable to.
  • More information about Advance Directives
  • Information about having serious illness conversation with your health care team

Talk to the people you trust and your health care team

  • It can be hard to talk about advance care planning.  Try these conversation starters.
  • Conversation starters in Punjabi, Simplified Chinese and Traditional Chinese.
  • If you are choosing a Substitute Decision Maker, talk to this person. Make sure they know your wishes and goals for care.  Make sure they understand their role in your care and agree to be your substitute decision maker.

Plan by recording and sharing your wishes with the people you trust and your health care team

Ask for help if you need it

Advance Care Planning can be difficult and confusing.  You may want someone to help you make decisions and help write your plan.  You can also talk to your health care team.

Be prepared, plan early

You can make an advance care plan at any time. However, the best time to make one is when you are healthy and make your own decisions.

As your life or your health changes, you will want to update the plan. You can change the plan as many times as you want and whenever you want.  Be sure to write down the changes to your plan. Tell your health care team and those you trust about the changes.

Examples of advance care plans

Tools to help you plan

The BC Centre for Palliative Care has information and resources to help you make an advance care plan.

Government of B.C. Advance Care Planning:

See BC Cancer Library Advance Care Planning Pathfinder for recommended websites, books, and handouts about advance care planning.

SOURCE: Advance Care Planning ( )
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