Questions & Answers
Scroll below to watch a short video explaining the 5 steps of Advance Care Planning.
This video is followed by commonly asked questions related to planning for our future health care needs and medical decision making.
What is Advance Care Planning?
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Thinking about your values and wishes and how they will influence your health preferences
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Investigating housing options that fit into your lifestyle in later years.
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Learning about specific medical treatments and options of care (i.e. CPR)
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Deciding on end of life care, rituals and preferred location of death
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Talking to others about your future health and personal care
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Writing down your wishes so they can be communicated to others
What is an Advance Health Care Directive?
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accompanies the formally appointed a power of attorney for personal care document
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outlines your preference for future health care needs
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outlines choices of residency/housing if you are unable to stay in your current home
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describes your beliefs, values, and goals and how this related to your quality of life
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describes what you wish not to receive in regards to medical interventions towards end of life
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allows for a statement of where you wish to live out your final days such as home, hospital or hospice
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can describe specific wishes such as last rights/pray and the people you wish to be around you in your final hours
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can and should be utilized by your POA to make future health and shelter decisions that align with your wishes
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can describe how you wish your POA to make decisions on your behalf
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is usually part of estate planning that includes direction of the management of your finances, property and health care
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Why plan for future health care and housing needs?
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will give you more control over medical decision making
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reduce your level of anxiety during very stressful times
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improve your quality of living
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alleviate the burden your substitute decision maker can feel by having to make difficult choices on your behalf
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prevents family tension when hard choices need to be made
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prevents unnecessary or unwanted treatments
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improves bereavement outcomes for loved ones
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What important information should I know about the role of a Substitute Decision Maker (SDM)?
This is the person(s) who will make decisions on your behalf when you are unable to speak for yourself due to a sudden or serious illness.
They will be responsible for:
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making medical decisions on your behalf
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deciding on care facilities should you require assistance
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ensuring your personal care needs are meet (clothing, food, transportation etc.)
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fostering previous relationships you have had with others
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communicating on your behalf
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A Substitute Decision Maker:
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Is enacted when you are unable to make your own health care decisions
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can refer to written documents/plans to help make decisions on your behalf
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can use Advance Health Care Directive, to guide your care and advocate for your wishes
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should understand your wishes and have a copy of your most recently written will- may need help or support from your family and friends when making a decision on your behalf if they are unclear what you would want
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How do I determine who will be my Substitute Decision Maker?
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Every person in Ontario has a SDM according to a ranking list within the Health Care Consent Act
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A Power of Attorney for Personal Care (POA) is a person you appoint to be your SDM
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A POA is the highest-ranking SDM unless the courts have appointed a SDM
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If you do not appoint a POA one will be appointed for you according to a ranking list
Ontario ranking order for determining who will be the Substitute Decision Maker:
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If there are two or more people who rank the same they will be equally entitled to act as your SDM (i.e. 3 children or 1 child and 1 parent, 5 cousins, 2 siblings etc.)
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If you have more than one Substitute Decision Maker they must:
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make decisions jointly
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come to an agreement on your care needs (it must be by consensus, NOT majority)
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if they cannot agree the default is the Public Guardian and Trustee
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It is wise to clearly make your wishes know to your SDMs
to avoid conflict and disagreement
In an emergency:
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There may be no time to get consent from anyone.
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Health providers will treat you without consent if it is necessary to relieve any pain or suffering or to address any risk of serious bodily harm.
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Once you are stable, the health care providers will need to determine who is your SDM and any further decisions will be made by your SDM if you remain unable to do so yourself.
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What important information should I know about the Power of Attorney (POA) for Personal Care?
A POA is a Substitute Decision Maker that you specifically appoint by completing specific legal papers.
Choose someone who:
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you trust and will be comfortable carrying out your wishes
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can make themselves available to speak with your health care professionals
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has a good relationship with those you love and care about you
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is not afraid to make tough choices for you that may or may not align with their own values
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is willing to spend time understanding your health preferences and their role
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How can I express my health preferences?
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orally, in writing or by any alternative means (video, tape recording, etc.)
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You can set out your wishes in a written document such as a “Living Will” or “Advance HealthCare Directive”.
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Anyone that acts as your SDM is required to follow your wishes regarding treatment, if known, however expressed.
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The “living will” has no particular “form” in Ontario and does not need to be witnessed or signed, however it is strongly encouraged that you complete some form of Advance Care Planning to ensure your health preferences are understood by those who may be required to make decisions on your behalf.
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What health care interventions or treatment might I be asked to make for myself or a loved one?
By learning more about medical terms and treatments, and legal requirements, you can make better choices for yourself and will be better equipped to support your family member regardless of the medical care they are receiving. For further information on medical terms, treatment options, and a description of the roles and responsibilities of the various health care professionals go to the "Let's Learn" Tab
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Can a request for Medical Assistance in Dying be put into an Advance Health Care Directive?​
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No, currently in Canada assisted dying cannot be part of a medical directive
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A person must be competent in order to request assisted dying, meaning that they must be able to provide consent themselves
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If faced with a serious illness, and assisted dying is something you would be interested in considering, it would be important to find out more information about criteria for accessing the service and to find a provider in your area.
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Preferences regarding assisted dying should be part of your advance care planning discussions and familiarizing yourself on your options at end of life.
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For more information regarding assisted dying please contact your physician.