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Navigating Advance Care Planning and Designations: A Guide for Albertans by Silvera For Seniors @ Westview Town Suites

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Navigating Advance Care Planning and Designations. Image source: SHUTTERSTOCK

In Alberta, Canada, it is crucial to prioritize advanced care planning (ACP) and Goals of Care Designations (GCD), particularly for people who face complicated medical decisions. To promote advance care planning, Alberta has established a program that covers the entire province. It's essential to understand ACP and its associated goals of care designations if you're a senior, caregiver, or someone planning for the future. Your healthcare preferences are critical, and they should be respected and upheld. Clear communication with your healthcare providers, family, and support network is necessary to ensure your wishes are known and implemented as healthcare decisions may influence the quality of your care and life. We will explore what ACP involves and delve into the Goals of Care Designations in Alberta.  

Understanding Advance Care Planning (ACP)

Advance care planning is a process that involves making decisions about your future healthcare preferences and ensuring that the care you receive aligns with your values and goals, even if you are unable to communicate them. In Alberta, Advance Care Planning (ACP) allows you to express your wishes regarding medical treatments and end-of-life care, and appoint substitute decision-makers to decide on your behalf, if needed. 

Advance Care Planning is an important tool to maintain control over your healthcare decisions. It empowers you to proactively document your healthcare wishes, ensuring that they are confidently respected and honored when the need arises. This reduces the emotional burden on your families during times of unexpected crisis, and puts you in a driver’s seat to advocate for your dignity and a higher quality of life. By making informed decisions about your healthcare, ACP provides you with a sense of control over your care, even in uncertain times. 

Engaging in advance care planning and choosing your goal of care designations is an essential step to ensure that your healthcare wishes are known, and that your loved ones and healthcare providers understand and respect them. In Alberta, this process involves several steps that need to be followed diligently. 

Personal Directive: A Personal Directive is a legal document that plays a crucial role in your advance care planning. It allows you to appoint a Substitute Decision Maker (SDM) and specify your healthcare wishes in case you become incapable of making decisions for yourself. The main aim of a Personal Directive is to ensure that your preferences for medical treatment and any end-of-life care are respected and followed. Alberta Health recommends that anyone over 18 should have one. 

Goals of Care Designation Order: A Goals of Care Designation (GCD) order is a medical document that outlines your preferences for medical treatments if you become unable to communicate them yourself. This document ensures that your medical care aligns with your goals and preferences, with a focus on comfort and quality of life rather than invasive treatments, if you so wish. The purpose of a GCD order is to ensure that your care is person-centered and in line with your wishes, enhancing your quality of life. Your doctor or healthcare practitioner will complete this medical document after you've discussed your preferences and medical problems with them. 

Before you start the conversation with your doctor, it's important to take some time to reflect on what matters to you. Consider your values, beliefs, and healthcare preferences, as well as various factors like medical treatments, end-of-life care, and quality of life that align with your preferences. 

The next step is to create a Personal Directive that outlines your healthcare wishes and appoints a Substitute Decision Maker (SDM), a trusted agent, to make decisions on your behalf if you are unable to speak for yourself. Please ensure that your Personal Directive complies with the legal requirements of Alberta. 

Apart from that, it is also valuable to prepare Power of Attorney (POA) documents, where you can appoint one or more trusted people with the authority to manage your finances and property in case you are unable to represent yourself due to mental incompetence or physical inability. This person(s) will then be known as your attorney-in-fact or agent(s). 

Once you have completed the above steps, it is important to discuss your advance care planning decisions with your loved ones, healthcare providers, and appointed agents to ensure understanding and alignment. This step is crucial as it helps avoid any confusion or misunderstanding about your healthcare preferences, especially in unexpected scenarios. 

Green Sleeve: What is it, and why is it important

Green Sleeve is a plastic green medical folder, known by Alberta’s health care providers, including ambulance and hospital staff to contain important medical documents pertaining to your advanced care planning instructions, especially in times of emergency or incapacity. It is a single source of truth for your wishes and medical treatment preferences so organizing it is very important. 

The Green Sleeve is a personal folder that should be kept in a visible area at home, such as on the fridge, and a copy given to your agent. It contains current medical documents, helping healthcare providers make informed decisions about your care in any situation. Always keep it with you, especially in emergencies, so that designated decision makers and goals of care can be easily accessed by the emergency team. 

The following items should be included in your Green Sleeve: 

• Personal Directive: This legal document appoints a substitute decision-maker (SDM) to make healthcare decisions on your behalf if you are unable to do so. Ensure that it is easily accessible.  

• Goals of Care Designation Order: This medical order translates your healthcare preferences into actionable directives for healthcare providers regarding resuscitative, medical and comfort care of your choosing. They ensure that medical treatments align with your goals and preferences, particularly if you are facing advanced illness or frailty.  

• Medication List: A comprehensive and up-to-date list of all medications you are currently taking, including dosage instructions and any allergies or adverse reactions you may have.  

• Emergency Contacts: This is a list of emergency contacts, including family members, friends, and healthcare providers, along with their contact information.  

• Healthcare Card: Your Alberta healthcare card or any other relevant health insurance card should be included for quick identification and access to medical services.  

• Allergies and Medical Conditions: Information about any allergies you have and relevant medical conditions or history that healthcare providers should be aware of during emergencies.  

• Legal and Identification Documents: Copies of important legal and identification documents, such as your driver's license, passport, and power of attorney documents, can be helpful for verifying identity and making legal decisions.  

• Healthcare Directives from Other Jurisdictions: If you have advance care planning documents from other jurisdictions, such as another province or country, it is advisable to include copies of these documents in your Green Sleeve for comprehensive care coordination.

• Contact Information for Healthcare Providers: Provide contact information for your primary care physician, specialists, and any other healthcare professionals involved in your care. 

Conclusion

It's important to maintain a well-prepared Green Sleeve in Alberta in order to ensure your healthcare wishes are easily accessible and can be honored in any situation. This will provide you and your loved ones with peace of mind. Engaging in advanced care planning and goals of care designations is crucial to maintaining your healthcare decision-making autonomy, especially in situations where it's difficult or impossible to plan last minute. By thoughtfully and proactively planning your wishes, you can ensure that your preferences for medical treatments and end-of-life care are respected and upheld. So, start the conversation today and take control of your healthcare journey in Alberta.