WHAT IS ADVANCE CARE PLANNING?
A way for you to ensure that your wishes regarding your health care are followed in a time where you may be incapable of expressing them yourself.
Advance Care Planning can include answers to questions such as, but not limited to:
Who do you want to make your health care decisions for you?
What health treatment(s) do you agree to, or refuse, if a health care provider recommends them?
Would you accept or refuse life support and life-prolonging medical interventions for certain conditions?
WHY DO I NEED AN ADVANCE CARE PLAN?
It gives you the opportunity to decide on your health care decisions in advance.
It is a guide for your loved ones and health care providers for providing you with the proper treatment based on your beliefs, wishes, and values.
DEVELOPING THE PLAN – BELIEFS, VALUES AND WISHES
Begin preparing your Advance Care Plan by considering your beliefs, values, and wishes regarding any future health care treatment, and making sure your loved ones and health care provider(s) are aware of them as well.
Things to think about include, but are not limited to:
Things that make your life meaningful (e.g. spending time with loved ones, hobbies, practicing faith);
What you take comfort in when thinking about your death (e.g. knowing any pain will be treated, believing you are in good care, believing in something after death);
What you worry about when thinking about your death (e.g. struggling to breathe, uncontrolled pain, loneliness); and
What you want as you approach death (e.g. having family nearby, someone holding your hand, the visitation of a religious leader, hearing about happy memories).
DEVELOPING THE PLAN – LIFE SUPPORT AND LIFE-PROLONGING MEDICAL INTERVENTIONS
Some of the hardest decisions regarding health care are the ones that deal with the use of life support and life-prolonging medical interventions.
Decisions dealing with the acceptance or refusal of life support and life-prolonging medical interventions include, but are not limited to:
Cardiopulmonary resuscitation (CPR);
All, some, or no life support or life-prolonging medical interventions a health care provider deems appropriate;
A trial period of life support and life-prolonging medical interventions, allowing a natural death to occur if your condition does not improve; and
Other life support or life-prolonging medical interventions that may result in you no longer being able to do things you enjoy.
CAPACITY In this case, health care provider(s) will ask you to make decisions about your own health care treatment.You are considered to have capacity when you …
Are capable of understanding and communicating with your health care provider(s); and
Are able to make your own health care treatment decisions.
A Section 9 Representation Agreement allows you to name a representative to make decisions about your personal care and health treatments, including decisions about accepting or refusing life support and life-prolonging medical interventions.
Completing a Section 9 Representation Agreement involves the following:
Discussing and writing down your beliefs, values, and wishes
Naming your representative and writing down your instructions using a section 9 form; and
Filling out a Temporary Substitute Decision Maker list.
An Advance Directive…Allows you to clearly state your decisions about accepting or refusing health care treatments while you are capable;
Provides health care provider(s) with instructions; and
Must be followed as long as it addresses the health care treatment you need at the time.
Completing an Advance Directive involves the following:
Discussing and writing down your beliefs, values, and wishes;
Outlining your decisions for future health care treatment; and
Filling out a Temporary Substitute Decision Maker.
INCAPACITY In this case, health care provider(s) will look to your Advance Care Plan as a guide for your health care treatment. You are considered to have incapacity when you …
Are no longer capable of understanding and communicating with your health care provider(s); and cannot make your own health care treatment decisions.
A Temporary Substitute Decision Maker (TSDM) is chosen if you have not legally named a Representative to make health care decisions for you when you are incapable of making them yourself.
The order of the people who qualify to be on your TSDM list is determined by B.C. law.
In order to act as your TSDM, the person must be 19 or older, have no dispute with you, and have been in contact with you in the past year.
Your TSDM is legally required to make decisions that respect your wishes.
One person on the list below must be approached in the order given:
2.A son or daughter
4.A brother or sister
7.Anyone else related to you by birth or adoption
8.A close friend
9.A person immediately related to by marriage (in-law, step-parents, step-children, etc.)
You may not change the order of the list. A person lower down on the list may only be chosen as your TSDM by your health care provider if all the people above them do not qualify. If you know you want someone lower on the list to make your health care decisions, then you should name that personal legally as your Representative using a Representation Agreement.
ENDURING POWER OF ATTORNEY
An Enduring Power of Attorney allows you, the Adult, to appoint another person as your Attorney to make decisions regarding your financial and legal affairs. The Attorney is authorized to act when you become incapable.
The powers provided to your Attorney(s) can be tailored to suit your needs. For example, this may range from the ability to deposit cheques into your chequing account to complete access to all of your assets.
Attorneys may not make health care treatment decisions. A Representation Agreement is the only way to appoint a Representative to act on your behalf for health care treatment decisions.