There are five important steps to begin planning: think, learn, decide, talk and record.
Think about what brings your life meaning, what brings you joy, what are your values, and what a good day looks like for you. Watch this video to help guide you in this exercise.
Learn about your current health and the treatments you may face in the future by having conversations with your health care team. This may include your doctor, nurse practitioner or other health care team members. See the conversations section for tips and guidance.
Decide who would speak for you if you’re unable to speak for yourself. Consider who knows you well, and who is willing and able to fill this role. Think about who could honour and follow your wishes. The person will be your substitute decision-maker.
Talk to people who matter to you about what brings your life meaning and how you would like to live. We may believe those close to us understand what matters to us most — but if we don’t say it, they might not know. Read some tips for starting these conversations.
Record your thoughts, such as your life goals, fears, worries, and priorities. Write your thoughts down in a letter, poem, video or audio recording and then share copies with people who matter to you.
We offer free, online, fillable and interactive workbooks to help guide you through the above five steps.
Who makes my health decisions if I can’t?
In British Columbia, the people who make health care decisions on your behalf are set out in law. This person(s) are called substitute decision maker(s) and are often a family member or close friend. They must honour your wishes, so it’s important they know what your wishes are. You can choose someone ahead of time by completing a Representation Agreement. Without an agreement, health care providers will follow a legal list set out by law called the Temporary Substitute Decision Maker List.
When thinking about who could be your substitute decision maker, consider the following questions:
- Do I trust this person to make health care decisions that reflect my wishes?
- Can they communicate clearly with my health care team?
- Can they make difficult decisions during stressful times?
- Is this person willing and available to speak for me if I can’t speak for myself?
It is important that your temporary substitute decision makers, your representative and others in your life know about the care you might want in the future. Here’s how to start the conversation with them [will link to new 'How do I talk about ACP webpage when it is published].
What is my role as a substitute decision maker?
You must be willing to accept the role of substitute decision maker for the person who has asked you. You need to thoroughly discuss their health care preferences with them, such as when to continue or stop life support measures, and to document these preferences.
For more information, view the video: Are you a Substitute Decision Maker?
What is a temporary substitute decision maker?
In British Columbia, to qualify as a substitute decision maker, the person:
- must be 19 years old
- have no dispute with you
- have been in contact with you in the year before you need the health care
If a temporary substitute decision maker is needed to make a health care decision for you, your health care provider will choose the first person on a list of your family/friend relations who is qualified, willing and available. The order of the people who qualify is determined by B.C. law and is as follows:
- Your spouse (married, common-law, same sex – length of time living together doesn't matter)
- A son or daughter (19 or older, birth order doesn’t matter)
- A parent (either, may be adoptive)
- A brother or sister (birth order doesn’t matter)
- A grandparent
- A grandchild (birth order doesn’t matter)
- Anyone else related to you by birth or adoption
- A close friend
- A person immediately related to you by marriage (in-laws, step-parents, step-children, etc.)
If you know that you want a particular person to make your health care decisions, then you should consider naming that person legally as your substitute decision maker using a Representation Agreement.
For more information, view these videos:
What is a representation agreement?
If you want to specify someone to make health decisions for you, you must complete a Representation Agreement.
If you select a representative, it is important to thoroughly discuss your health care preferences with them as well as others in your life, such as when to continue or stop life support measures, and to document these preferences.
What should you consider when choosing a representative?
It is important the person whom you choose as a representative know what your wishes are so they can honour them. Having conversations is the best way to ensure this.
To make these decisions, they can use the information in your Advance Care Plan, statements made by you in the past, and what they know about you personally.
How do I make a representation agreement?
There are two types of Representation Agreements: one, known as a Section 7, allows for the representative to make personal care and some health care decisions excluding refusal of life support or life-prolonging treatments; the other, known as a Section 9, allows for personal and health care decisions including accepting or refusing life support and life prolonging treatments.
For more information about Representation Agreements, visit the Advance Care Planning page on HealthLink BC.