Conversations Matter- Advanced Care Planning- Alberta Style

Originally published in on May 5, 2014:

Last week I had the pleasure of attending the Conference Board of Canada’s Council on Healthy Aging conference called “Healthy Aging: The Importance of Financial Care for Canadians”. It was a wonderful event which brought together experts from across the country to talk about issues and trends.

One of the presenters was the Provincial Medical Advisor from Alberta Health Services, Dr. Eric Wasylenko, and he spoke about an initiative on Advance Care Planning that has been recently implemented in that province. This is a forward thinking approach to assist all Albertans to be better prepared and informed regarding their own health care.

Advance Care Planning “is a way to help you think about, talk about and document your wishes for health care. It is a process that can assist you in making healthcare decisions now and for the future.”
Alberta has taken a lead role in implementing this approach to care. The approach provides for your values and wishes to be discussed with your own physician and family and documented so that you the patient can have your wants and wishes respected and followed, when you may no longer be able to speak for yourself.

“Goals of Care Designations are used by your healthcare providers to describe the general aims of your health care and the preferred location of that care. In a medical emergency, your Goals of Care Designation guides your healthcare team to provide timely care that best reflects your health condition, the treatments that will be of benefit to you, and your own wishes and values.”

Their information booklet (which is contained in what they refer to as the ‘Green Sleeve’) describes three general approaches to care or Goals of Care Designations and include:
 “Resuscitative Care-The focus is to prolong or preserve life using any medical or surgical means including, if needed, resuscitation and admission to Intensive Care
 Medical Care- Medical tests and interventions are used to cure manage an illnesses well as possible but don’ use life support measures
 Comfort Care- The aim of medical tests and interventions are for optimal symptom control and maintenance of function when cure or control of an underlying condition is no longer possible or desired.”
In their booklet and website Conversations Matter a process is outlined that includes a series of steps, including:
1) Think about your values and wishes
2) Learn about your own health
3) Choose someone to make decision and speak on your behalf
4) Communicate your wishes ad values about health care and
5) Document in a Personal Directive.

This Personal Directive comes into effect “if there is ever a time that you are unable to make decisions about your health care. It can be helpful in reducing conflict or distress and bringing comfort to those who are close to you, because it clearly states who your healthcare decision maker is and can provide guidance about your wishes.” The Personal Directive “can, and should be reviewed any time you have a change in your health circumstances or your wishes and values.”

This important document becomes your philosophy and approach to living as well as your philosophy of dying. It helps guide the conversation which can also be physician led. The time to think about your values, wishes and desires is now, before a crisis hits and you are unable to speak for yourself. More information is available at

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