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What is Advance Care Planning and How Do You Choose Who Will Represent You?

Advance Care Planning is the process of deciding and documenting who is your voice and to what extent you want medical treatment in the event of your mental incapacity.

Many people have shared with me that their ideal way to die is to go to sleep and not wake up.  Certainly some people do die this way.  In reality however, many people will have a longer process involved in their future care before they die.

How do you set up an Advanced Care Plan?

When you draft your Power of Attorney for Personal Care you are appointing a person called a Substitute Decision Maker (SDM) to be your voice in the event of your mental incapacity.  In this document you can outline your wishes concerning your personal care in respect to: healthcare treatment and services, food preferences, shelter, housing, clothing, personal hygiene and safety. Your SDM should be a person you trust, who understands your values and beliefs and is willing and able to act on your behalf when you cannot. Your SDM only makes decisions for you when you are incapable of making them yourself.

What does mental incapacity mean?

Mental incapacity refers to the notion that you are no longer mentally capable to understand the medical information about your condition, the recommended and proposed treatment(s) nor the alternatives to proposed treatment(s), and the likely outcome of accepting or refusing treatment(s).  In this situation the healthcare providers will take direction from your SDM who must act in your best interest.

Who cannot be a SDM?

  • A person who is paid to provide care to you
  • A person who is mentally incapable
  • A person under the age of 16

What if a person is mentally incapacitated and does not have a SDM?

In the absence of a Power of Attorney for Person Care with a nominated SDM the health care system must, in accordance with the Health Care Consent Act (1996), follow the hierarchy of substitutes outlined in Table of Sanguinity in choosing the person to make healthcare decisions for you.  This person will be the highest ranking person who is of mental capacity and older than 16 year, based on other criteria in this order:

  1. Your Spouse, common-law spouse/partner.
  2. Your Child or Parent.
  3. Your Parent with right of access only – custodial parents rank ahead of non- custodial parents.
  4. Your Brother or Sister.
  5. Any other relative by blood, marriage or adoption.

An exception to following this hierarchy would arise in the event of a medical emergency where healthcare providers may not know your wishes and have to act quickly.

It is important that you act now while you have capacity to think through and document what you would like your healthcare plan to look like in the event of your mental incapacity.  This will not only give you peace of mind but also those who care about you.

These free resources are available for you to find more information:

Who would you choose as your Substitute Decision Maker (SDM)?  Have you started preparing for this?  If you or your SDM have any questions, or if you’re not sure what is important to have organized or how to do this than please click on the link below to purchase your PDF copy or hard copy of the Taking Care of Business – Executors Workbook to help you get started on being organized.  You can connect with me via email or telephone, leave a comment here on the site or click the contact tab at the bottom of the screen if you are reading this post on the website. Don’t forget to join in the conversation on Facebook and Twitter too!

Until next time,


Katherine Downey is the #1 Funeral Preplanning Professional in Canada for the fourth time. She is a professional educator, author, licensed funeral director and insurance advisor. To set an appointment or have your questions answered, please contact Kat directly.

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