Informational Handout

What is Advance Care Planning?

Advance Care Planning is part of life planning, just like estate and financial planning.

Advance care planning is a process of:

  • thinking about your values, beliefs, and wishes for future health care and personal care, and
  • sharing them with the people you trust (your family, close friends, and health-care providers)

It can include choosing who would make care decisions for you if you cannot.

Advance Care Planning can help you get the care that’s right for you, even if you’re unable to speak for yourself.

Advance Care Planning is something we should all do, whether we are healthy or unwell, young or old.

Remember three simple words to guide your Advance Care Planning: Think… Talk… Plan

Steps for Advance Care Planning

THINK: What matters most to you?

Decisions about health care are guided by your values or beliefs. For example, some people may want to live as long as possible, whatever it takes. Other people may not want to have tests and treatments that may not help. As your life and health change, what matters to you may also change.


Some questions to guide your thinking:

  • What is most important to you?
  • What would matter to you if you became unwell and couldn’t communicate?
  • Are there things you already know about your preferences for health and personal care?
  • What concerns you when you think about your future state of health?
  • How do you prefer to make decisions about your health? Who is involved?
  • What personal wishes are important to you?
    For example: Where do you want to be cared for? What spiritual or cultural practices would you like to observe?

THINK: Who could make decisions for you if you cannot?

As long as you can understand information about your care options and can communicate your wishes (you are capable), you will be asked to make decisions and provide informed consent for any health-care treatments. Informed consent means agreeing to a treatment when you understand its purpose, benefits and risks.

You also have a right to receive support in your decision making from the people you trust to help you:

  • understand the information provided, and
  • communicate your wishes.

If you have to make a decision but have trouble understanding the information presented, even with support, someone else will be asked to make that decision for you. This person is called a substitute decision maker.

If you know who you’d like this to be, you can name them as your representative. If you do not name someone, a temporary substitute decision maker can be appointed by a health-care provider, or a guardian can be appointed by the Court.

A good substitute decision maker is someone who

  • knows you well, and understands your values, beliefs and wishes for health and personal care
  • honours your wishes and instructions when making decisions for you (this is their legal role), even if their wishes are different from yours
  • can communicate with health-care providers, advocate for your wishes, and not be pressured into accepting care options that you wouldn’t want
  • is calm in a crisis
  • can handle conflict or disagreement
  • is willing and available to take on the role


A substitute decision maker you choose for health-care and personal-care decisions.

Your representative can make personal-care and health-care decisions for you if you cannot make these decisions yourself.

They must be an adult (age 19+) who has agreed to make decisions on your behalf. In BC, you can name one or more people as your representative(s).

The legal document you use to name a representative is called a representation agreement.

Representation agreement

A legal document you can make to appoint a representative.

There are two types of representation agreements:

  1. Section 9 can be used by a person who can make their own decisions, and can include personal-care* and health-care decisions. It can include decisions about life support and life-prolonging treatments.
  2. Section 7 can be used by a person even if they do not understand some information, and can include routine financial, legal, personal-care* and health-care decisions. It cannot refuse life support and life-prolonging treatments.

(*Personal care refers to the daily living needs of individuals, such as living arrangements, diet, clothing, hygiene, exercise, and safety).

Representation agreements may be created without a lawyer or notary’s involvement.

Temporary substitute decision makers

A substitute decision maker chosen for you for health-care decisions only.

If you need a temporary substitute decision maker , your health-care provider will work down the following list to identify the first available person who qualifies** and is willing to act as your temporary substitute decision maker:

  1. Your spouse, including common-law, same sex (the length of time living together doesn’t matter)
  2. One of your children (equally ranked)
  3. A parent (equally ranked)
  4. A sibling (equally ranked)
  5. A grandparent (equally ranked)
  6. A grandchild (equally ranked)
  7. Anyone else related by birth or adoption
  8. Close friend
  9. Person immediately related by marriage

If no one can be reached or qualifies, a Public Guardian and Trustee will be appointed.

**The person must be: 19 years of age or older, capable of making decisions, have no dispute with you, and have been in contact with you in the past year.

Advance directive

A legal document that records your instructions for accepting or refusing specific health-care treatments, for a time when you aren’t capable of providing consent.

It is used when it speaks to the health-care condition and treatments in the specific situation. An advance directive gives instructions directly to your healthcare provider. It is important to talk with a health-care provider before making an advance directive.

If you have a representation agreement and an advance directive

If you need health care and cannot speak for yourself, your health-care provider will ask your representative to make these decisions for you. Let your representative know they need to treat the instructions in your advance directive as your wishes.

If you don’t want your health-care provider to ask your representative to make decisions covered in your advance directive, you need to clearly state this in your representation agreement.

Series of young Malay couple with elderly women having conversation over coffee

TALK: With the people you trust

Talk to your substitute decision maker and other people you trust. You need to talk to them so they know what you would want.

Talk about:

  • what matters most to you
  • who you have chosen as your substitute decision maker; ask others to support this person
  • who you would like to be told about your health and be involved in health-care decisions

TALK: With your health-care provider

Share with them who your substitute decision maker is, any specific wishes or instructions for care, and if you are considering an advance directive. As you age or if you have a serious illness, also ask them about what to expect in your future health.

Consider involving your substitute decision maker in these conversations. It will help them if they ever need to make decisions for you.

PLAN: Record your wishes

Prepare an advance care plan by:

  • writing down or recording what matters most to you and your future health-care wishes, and
  • Contact info of your potential temporary substitute decision makers. You can include notes on people who would not be eligible on your temporary substitute decision maker list and why.

Include your representation agreement and advance directive if you have them.

Store your plan in a safe place where it can be easily located if needed. Documents needed by first responders must be accessible to them (for example, on your fridge).

PLAN: Share copies of your plan with:

  • Your representative (if you have one).
  • People who may be appointed as your temporary substitute decision maker.
  • Your close family and friends
  • Your health-care providers

Remember to bring your advance care plan with you if you go to the hospital.

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REVIEW: Your plan

Advance care planning isn’t just a one-time event. As your life and health change, what matters to you may also change.

Review your plan whenever something changes, such as a change in substitute decision maker, a change in your wishes, or a new diagnosis.

Update your substitute decision maker, the people you trust and your health-care providers with any changes in your wishes.

Give them updated copies of your advance care planning documents, and let them know where the documents are stored.

For more information visit

For more resources to help you get started, visit

Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.

This work is licensed under a Creative Commons Attribution-Noncommercial-NoDerivatives 4.0 International License.

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