We can’t know what health care decisions we may face in the future and, in Ontario, leaving behind a note with your wishes will not be considered legally binding. If you become incapacitated, you have to have a person designated to speak and act on your behalf. A Substitute Decision Maker (SDM) or Power of Attorney for Personal Care needs to know your wishes. This is the person who health care providers will ask to make health care decision for us, sometimes in crisis situations with little time and a lot emotion.
“The COVID-19 pandemic has put a sharp focus on Advance Care Planning or ACP,” says Rick Firth, President and CEO of Hospice Palliative Care Ontario. “ACP is the process of confirming who your Substitute Decision Maker is, or the person who will speak for you if you’re incapable of speaking for yourself in health care situations, and talking to that person about what matters most to you in life.”
Here are five steps we all need to take:
1. Identify your designated Substitute Decision Maker (SDM) by going to the Speak Up Ontario website to find the Substitute Decision Maker hierarchy. It is most often a close relative. If you’re not satisfied with who is legally designated then you can appoint a Power of Attorney for Personal Care through the POA for personal care form.
2. Learn about your overall health, any health problems and possible future treatments you might need.
3. Think about what matters most to you – your beliefs, values and wishes for how you want to live – the things that would inform your future health care decisions.
4. Talk to your Substitute Decision Maker or Power of Attorney for Personal Care about your health, your future health and what things in your life are important to you and will inform your health care decisions. Saying we want to be saved at all costs or we don’t want to be resuscitated, isn’t helpful. Health care decisions are not always that clear cut. Treatment options come with pros, cons, and possible risks and benefits, and those are based on multiple factors that will vary over time – age, overall health, extent of illness or injury, and current context.
5. Include your Substitute Decision Maker in your thinking as it evolves. Verbally conveying it is enough, but it can help to write your thoughts down or tell other important people in your life, so they can be prepared to support you when decisions have to made.
Go to the Speak Up Ontario website and click on Individual and Family Resources for guidance on having ACP conversations. Because we can’t know what will happen, or when.