WHAT IS INFORMED CONSENT?
Informed consent is the capacity to make informed decisions about your life. Mental capacity is determined by the health care professional proposing a specific treatment or course of action. If you are found to be incapable of making health care decisions, you have the right to consult the Consent and Capacity Board to review this finding.
The health care provider who finds you incapable must tell you of this right. Health care providers must explain in detail any tests or treatments you undergo, including:
- Risks, benefits and side effects
- Alternatives to these options
- What may happen if you refuse these options
Before you consent to treatments, procedures or therapies, health care providers must answer questions you have about them.
A person’s capacity can be determined by a health care professional proposing a specific treatment or course of action. If you are found to be incapable of making health care decisions, you have the right to consult the Consent and Capacity Board to review this finding. The health care provider who finds you incapable must tell you of this right. A substitute decision maker or a Power of Attorney must also be considered to make decisions on your behalf.
The health care provider who finds you incapable must tell you of this right. A substitute decision maker or a Power of Attorney must be considered to make decisions on your behalf if you are not deemed to be capable of making your own decision.
WHY IS ADVANCE CARE PLANNING IMPORTANT?
You have the right to make choices about your body. However, accidents, trauma, diseases and conditions, such as cognitive impairment, dementia, and Alzheimer’s Disease can diminish your ability to make decisions.
Making an Advance Care Plan allows you to name the person (s) who will make decisions for you in the event that you are unable to make these decisions yourself. It also communicates your wishes regarding many health issues, including:
- Diagnostic and medical procedures, whether these are preventive, therapeutic, or cosmetic.
- Interventions to prolong life.
- The type of care you want should you be unable to care for yourself.
- Palliative and hospice care options.
Accidents and unexpected illnesses can arise at any time, so communicating an Advance Care Plan is important at any age. Families and physicians greatly benefit from knowing ahead of time what you want.
For older adults, there are even more reasons to engage in advance care planning:
- Decisions about medical care may be more frequent, and the need to make medical decisions is more likely as you age.
- The possibility or necessity of moving into a retirement residence or into long-term care may compel individual or joint family decision-making.
- End-of-life decisions are closer.
- Children may live far away and be unable to provide immediate assistance.
The physical and social effects of ageing often present new challenges. Advance Care Planning can help you meet these with confidence and grace.
WHAT SORTS OF DECISIONS ARE INVOLVED IN ADVANCE CARE PLANS?
Many of us have a general idea about end-of-life care, and can easily communicate in words to a spouse or to children that, for example, a Do Not Resuscitate (DNR) order is desirable. However, an Advance Care Plan can go into greater detail, and include a level of specific preferences that may involve any of the following:
- Who you want to make decisions for you (you cannot name someone paid to look after you unless this is a spouse, partner or relative; nor can you name anyone who is under 16 or is mentally incapable of making health care decisions).
- What you want related to personal care, such as where you want to live, what you want to eat and wear.
- What kind of health care you want, such as admission or discharge from a medical facility, or moving into or receiving personal care in along-term care home.
- Whether you want to be resuscitated should you suffer a stroke, heart attack, medical emergency or an incapacitating accident.
- What your intentions are should you be referred to palliative care.
WHAT ADVANCE CARE PLANNING IS NOT
Advance Care Planning communicates your wishes. It is not advance consent to any particular treatment nor an Advance Directive for treatment. An advance care plan that expresses your wishes for personal care is not legally binding. However, it does make decisions easier for the people who will care for you if you cannot do so yourself, and makes your wishes more likely to be followed.
WHAT ARE THE BENEFITS OF ADVANCE CARE PLANNING?
The benefits of Advance Care Planning are personal, familial and social.
- Your family, friends and medical professionals will benefit from knowing what you want. You will benefit from conversation, as you may change your mind while you talk about different aspects of values, expectations and preferences.
- Advance Care Plans can reduce hospitalization at the end of life and ensure you get the care you want.
- Some health care options may be ineffective or harmful for older adults. Thoughtfu consideration of your choices, preferably before the time when these may be urgent, can help avoid fruitless interventions.
WHAT ARE THE CHALLENGES OF ADVANCE CARE PLANNING?
Despite the benefits of Advance Care Planning, many are hesitant to create a plan, and almost half of older adults never do so. This may be due to one or several reasons:
- Many of us are reluctant to discuss illness and death.
- Perspectives on life may shift as we get older.
- Loss of a spouse, sibling, child or friend can create feelings of isolation that hinder decision-making.
- Physical, cognitive and psychological changes may cause us to postpone decisions.
- Some health care professionals aren’t comfortable or well trained enough to discuss end-of-life topics and hesitate to raise these with patients. Discussion with family and friends before you raise the topic with your doctor or caregiver will allow you to lead the discussion.
WHAT ARE DECISION-MAKING STRATEGIES IN ADVANCE CARE PLANNING?
There are many ways you can gain more information about advance care planning and end of life care that can help you clarify your wishes and communicate them to others. Some strategies include:
- Considering carefully your own values, beliefs and resources when exploring
information about choices. “What makes life meaningful?” is one question you may want to consider. - Having conversations about your future as you age. Advance Care Plans can be
difficult to discuss, as illness, mental incapacity and death are topics we often avoid. If no-one else is available, a family doctor or a lawyer can clarify options and open the way to meaningful consideration. - Seek out information related to health care, shelter, clothing,nutrition, hygiene,
personal safety and end of-life care. Many organizations provide information about. these issues. A family doctor or members of your family may be helpful as well. Try using films, books, magazine articles, websites and personal conversations with friends or family as starting points for information about advance care.
WHERE CAN I FIND MORE INFORMATION?
POWER OF ATTORNEY FOR PERSONAL CARE KIT – MINISTRY OF THE ATTORNEY GENERAL
Information about Naming a Power of Attorney and for the Power of Attorney for Personal Care Form, visit the below website to download the full kit.
ADVANCE CARE PLANNING – SPEAK UP CANADA
Information about advance care planning and making a plan for future health decisions.
HOSPICE PALLIATIVE CARE ONTARIO
Provides resources to navigate end-of-life decisions, including a guide to Advance Care Planning in Ontario.
Modified: 2021-07-05
We would like to thank the following for their support of our Education Resources to Support Healthy Ageing Initiative
- Mon Sheong Foundation and the Ben and Hilda Katz Foundation have generously provided funding to support printing and translation of our Education Resources to Support Healthy Ageing.
- The Ministry for Seniors and Accessibility supported this initiative with funding through its Seniors Community Grant Program.