This is a verbal or written summary of a capable adult’s wishes or instructions about the kind of care they want or do not want in the event that they cannot speak for themselves. An advance care plan can be written down or simply told to someone who will likely be asked to speak on behalf of an individual (Substitute Decision Maker) if no Proxy has been named in a legally binding Health Care Directive. It can guide a Proxy or Substitute Decision Maker if that person is asked by a health practitioner to make treatment decisions on your behalf.

Advance care planning is a process of reflection and communication, a time for you to reflect on your values and wishes, and to let others know your future health and personal care preferences in the event that a health practitioner determines you are not capable to either make and/or communicate your own healthcare choices. Advance care planning means having discussions with family and friends, especially your Proxy (if you have named one in a legally binding Health Care Directive), or with family and friends who may be called upon to be your Substitute Decision Maker (the person who will speak for you) if a Proxy has not been named in a Health Care Directive. It may also include preparing a written Advance Care Plan, creating a Health Care Directive, and may even involve talking with healthcare providers and financial and legal professionals.

Medical term meaning decisions NOT to have any treatment or procedure that will delay the moment of death. It applies only when death is about to happen from natural causes, and you would still receive treatments to keep you comfortable (e.g. pain medication, oxygen, etc.). The continuation of nutrition and hydration in the vast majority of cases is not part of comfort measures.

The transfer of blood or blood components from one person (the donor) into the bloodstream of another person (the recipient). Blood transfusion may be done as a lifesaving maneuver to replace blood cells or blood products lost through bleeding or due to depression of the bone marrow.

A person has capacity with respect to treatment if a person is, in the health practitioner’s opinion, able:

• to understand the information that is relevant to making a decision concerning the treatment;
• to understand the information that applies to his or her particular situation;
• to understand that the person has a right to make a decision; and
• to appreciate the reasonably foreseeable consequences of a decision or lack of decision.

Medical term meaning the medical procedure used to restart your heart and breathing when the heart and/or lungs stop working unexpectedly. CPR can range from mouth-to-mouth breathing and pumping of the chest to electric shocks that restart the heart and machines that breathe for the individual. CPR can be useful in some situations, but not in all situations.
Watch a video about CPR
Learn if CPR is right for you

Treatments to keep you comfortable (for example, pain relievers, psychological support, physical care, oxygen, etc.) but not to keep you artificially alive or cure any illness. The continuation of nutrition and hydration in the vast majority of cases is not part of comfort measures.

Medical term meaning the procedure that cleans your blood when your kidneys can no longer do so.

This is health care provided at the end of a person’s life. This type of care focuses on you living the way you choose during your last days or weeks. Care provided during this time may be called supportive care, palliative care or symptom management. End of life care addresses physical, psychological, and spiritual concerns and focuses on comfort, respect for decisions, and support for the family. It is provided by an interdisciplinary group of health care providers.

Medical term meaning a surgical intervention to feed someone who can no longer swallow food.

A communication and decision-making process that occurs between a clinician and a patient to establish a plan of care usually within an institutionalized setting, that follows a prescribed communication process. It is intended to clarify and document goals of the treatment plan that assures patients’ wishes are met to address relief of suffering, quality of life, support for family and loved ones and end-of-life care.

The term “guardian” means a person authorized or appointed to exercise powers for a person who is mentally incompetent or is incapable of managing his or her personal affairs.

This is a legally binding document in which you explain, in writing, your wishes about health care and treatment in case a health practitioner has determined you are not capable to either make and/or communicate your own healthcare choices. In your directive, you can appoint another person, called a Proxy, to make health care decisions for you when you are not capable to either make and/or communicate them yourself. Anyone who is 16 years of age or older and capable of making health care decisions can make a directive.

A Health Care Directive needs to be in writing, and be dated and signed in order to be valid. A Health Care Directive never takes priority over a capable person’s consent

Your Health Care Directive may be very detailed about what treatments you want or don’t want, or may be a general outline of your values, beliefs and wishes, without details. Your directive will guide your Proxy or Substitute Decision Makers in the decisions to be made about your treatment when a health practitioner has determined that you’re not capable of doing this yourself.

Learn more about the legal requirements of a Health Care Directive in PEI

A person who is registered or licensed to provide medical treatments, such as a doctor, dentist, nurse, physiotherapist, etc.

Medical term that means giving you fluids or medications through a vein in your hand or other part of your body using a a syringe or intravenous catheter (tube).

This is a way to give you fluids or medicine through a vein in your hand or another part of your body.

Medical term meaning health care treatments like tube feedings, ventilators (breathing machines), kidney dialysis, medications, and cardiopulmonary resuscitation. They are considered medically appropriate care when the goal of care is to continue or prolong life. All of these use artificial means to restore and/or continue life. Without them, you would die.

Medical term meaning any invasive operative procedure in which a more extensive resection is performed, e.g. a body cavity is entered, organs are removed, or normal anatomy is altered.

Medical term that refers to allowing organs and/or tissues to be donated in certain circumstances under The Human Tissue Donation Act. Although advance consent is not permitted, a person can register their wishes about donating their organs and/or tissue or state their wishes in a Health Care Directive.

Medical term referring to specialized care for people with serious illness focused on providing management of symptoms such as pain, physical stress and mental stress of a serious illness whatever the diagnosis. The care may include medicine, treatments, physical care, psychological/social services and spiritual support, both for you and for those who are helping to care for you.
Learn more about palliative care

Allows you to appoint someone to make financial and legal decisions on your behalf should a health practitioner determine that you are not capable of making decisions on your own behalf. In PEI, a power of attorney has authority in relation to finances only and has no decision making authority over health care decisions. (In PEI you will need to do a Health Care Proxy appointment for this purpose)

The role of a Proxy is to consider your expressed wishes and best interests when treatment decisions need to be made on your behalf. It is a good idea to appoint a substitute/second Proxy who would act if the first Proxy predeceases you or is unable to act. When the decision of a Proxy is required and the directive does not give specific instructions, the Proxy shall make a decision based on your best interests. If you name more than one Proxy, you can indicate how you wish them to act: SUCCESSIVELY (second Proxy decides if the first Proxy is not available) or JOINTLY (make decisions together). If how you wish them to act is not indicated, Proxies shall act successively.

To be valid, a health care directive must be written, dated, and signed by you. Any Proxy you name must also sign the section of the form where they agree to be your Proxy. If your named Proxy/Proxies have not signed the form, their appointment is not valid.

If you cannot sign the directive yourself, someone else can sign the directive for you at your direction. If someone else is signing for you, you will also need a witness. The witness can’t be your Proxy or your Proxy’s spouse. You, your signer, and the witness must all be present when your directive is signed.

In PEI, spouses are defined as two people who are legally married or two people who have lived together in conjugal (sexual) relationship for at least 3 years. Two people who are living together in a conjugal (sexual) relationship and are the natural or adoptive parents of a child or children are considered spouses even if they have not been living in a conjugal (sexual) relationship for three years.

A substitute decision maker is someone who makes health care decisions on your behalf when you are not able to do so yourself.

• It may be someone you formally appoint to make health care decisions for you (known as a Proxy),
• or it could be someone else who is chosen based on the directions set out in the Consent to Treatment and Health Care Directives Act.
• If you have formally appointed a Proxy, that is the person who will be your substitute decision maker for health care decisions.
• If you have not formally appointed a Proxy, or the appointment is not done properly (it has to be in writing, signed and dated, and the person being appointed has to have agreed in writing to do so), or your Proxy is not capable, available or willing to act when called upon to make a health care decision for you, then the Consent to Treatment and Health Care Directives Act provides a list of who can fulfill the role of substitute decision maker for you, and in what priority.
• A substitute decision maker must be at least 16 years old and be capable of making health care decisions themselves.
• In addition (except for a Proxy), a substitute decision maker must have knowledge of you circumstances and have been in recent contact with you at the time they are being asked to make the health care decision for you.

Medical term referring to signs that you are unwell - for example, pain, vomiting, loss of appetite, or high fever, shortness of breath, confusion, weakness, etc.

Medical term referring to an incurable medical condition caused by injury or disease.

Medical term referring to a machine that helps a person breathe when they cannot breathe on their own.

Your Proxy will make medical decisions for you if you are unable to do so. They also are required to honour and respect your wishes and instructions. Here are some things to consider when thinking about who would be a good Proxy:

• Do I trust this person(s) to make health care decisions that reflect my wishes?
• Could this person(s) honour my wishes even if it went against their own values?
• Can they communicate clearly with my health team and my other family and friends?
• Can they make difficult decisions during stressful times?
• Is this person willing and available to speak for me if I couldn’t speak for myself?
• Have I talked enough with this person(s) so they clearly know what I want and what I don’t want?

Your personal circumstances change over time. As long as you are capable, you can change or cancel (revoke) your Advance Care Plan and/or Health Care Directive at any time.

Make sure you regularly review your Advance Care Plan, and your Health Care Directive, and make sure that your Proxy (if you still want him/her to be your Proxy) is still willing and able to make decisions for you if you are in a situation where you cannot speak for yourself. If you make any changes to your Health Care Directive, it is your responsibility to destroy your old copies, inform anyone you’ve given copies to that you have made changes, and provide them with copies of the updated Advance Care Plan and/or Health Care Directive, requesting that they also destroy any old copies in their possession.

Before changing or cancelling your Advance Care Plan be sure you have up-to-date knowledge about your current health condition and any new health care treatments available to you.

Remember that you can change your Health Care Directive at any time. If you make any changes to your Health Care Directive, it is your responsibility to destroy your old copies, inform anyone you’ve given copies to that you have made changes, and provide them with copies of the updated document, requesting that they also destroy any old copies.

There are many ways to get the conversation started! Remember, it may take a few attempts to get things started. Don’t feel like you have to have the entire conversation at once.

Be Straight Forward

• "I have just filled out a workbook about my wishes for future health care and I want to share it with you."
• "My health is good right now, but I want to talk to you about what I’d want if I was sick and needed you to make decisions for me."

Find an example from your family or friends

• "Does anyone know how Jason’s sister died? No one ever talked about it. I wonder if she died at home or in a hospital?"
• "Do you remember my friend Frank who was in a coma for a while? I wonder if there was any argument about keeping him on that ventilator?"

Find an example from your everyday life.

• "Pastor Jones was talking about our choices for health care if something happened, and I realized that I haven’t told you about my wishes – we should talk about that."
• "My doctor wants me to think about my future health care and to make an Advance Care Plan. Will you help me?"

Find an Example From the News

• "Remember the man who was in a coma for years? I would never want that to happen to me."
• "That story about the family fighting about their mom’s care made me realize that we should talk about these things so the same thing doesn’t happen to our family."