FEATURE ARTICLE
Stay in Charge: Advance Care Planning
Adapted from
"Decide for Yourself: Why You Must Write Your Power of Attorney and Personal Directive"

Advance care planning is a process in which a capable person makes decisions with respect to his or her wishes for future medical care and treatment, and personal care in the event they are not able to give informed consent. These health care directives may:

• Appoint a "proxy" who will assume responsibility for ensuring the person's wishes are respected
• Contain health and personal care wishes that must be followed by health care providers, where the wishes are reasonable, possible, and legal.

The first type is called a proxy directive. All provinces, the Yukon, and the Northwest Territories allow proxy directives.
The second type is called an instructional directive.  Several provinces allow this type of directive, as well as the proxy directive.

Why have a directive? Manitoba Health provides this general suggestion for writing a health care directive, or "living will."

"Due to accident or illness, you may become unable to say or show what treatment you would like, and under what conditions. If you have signed a directive, those close to you and the health care professionals treating you are relieved of the burden of guessing what your wishes might be."

Each province has specific legislation regarding health care directives. The ElderWise Guide, "Decide For Yourself", provides web links to the specific details for each Canadian province and territory. You must comply with the legislation in your parent's province if the directive is being prepared for them.

Here is a scenario that is all too common for families who do not have advance care planning in place (names changed to protect privacy):

Clarence was 87 years old and had not named anyone to speak on his behalf. When his niece raised the topic, he said: "You'll be there for me - and I know you will do the right thing." But when Clarence had a stroke and was temporarily in a coma, his niece was unable to legally speak on his behalf because she had not been specifically named as Clarence's representative.

Here are the steps to putting a directive in place:

• Research the information that applies to your province ("Decide for Yourself" includes web resources for all provinces and territories).
• Discuss medical treatments, such as a "Do Not Resuscitate" order, with your physician.
• Decide who will speak on your behalf AND get their consent.
• Write the directive yourself - or get help from a lawyer.
• Provide copies of the directive to your family, your physician, and the person(s) named in the directive.
  
  Get full details about the contents of "Decide for Yourself"
  
  Vol. 5, No. 8 � ElderWise Publishing 2009.
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