National Framework on Advance Care Planning released

Feb 02, 2012

Report aims to ensure Canadian’s voices are heard
Most of us hope to be able to communicate to the very end of our lives – but it doesn’t always happen that way.  A Task Group representing over 25 associations across Canada has released its National Framework For Advance Care Planning,  with the goal of providing guidance for implementing this importance practice into our health system to ensure that your voice is heard – even when you cannot speak for yourself.

“Many people think of advance care planning as being the same as filling out a living will or having a “Do Not Resuscitate” order in your medical file,” says Sharon Baxter, Executive Director of the Canadian Hospice Palliative Care Association (CHPCA) and a member of the Task Group. “But advance care planning is really more about the conversations that we have – over time - with our family, our friends and our health team. It’s something that we all need to do.”

Advance Care Planning is a process of reflection and communication to ensure others are aware of your preferences for care if you cannot speak for yourself. Your plan may include information about procedures such as CPR and mechanical ventilation, as well as other personal information, such as spiritual preferences or specific wishes for family members or friends. One of the most important aspects of advance care planning is naming and having a conversation with a Substitute Decision Maker - someone who will speak on your behalf and make decisions for you – but only when you are not able to do so yourself.

A 2008 study found that the absence of Advance Care Planning, in all its forms, was associated with worse patients’ ratings of quality of life in the terminal phase of the illness and worse ratings of satisfaction by the family during the terminal illness or in the months that follow death. Research also indicates that patients who have end of life conversations with health professionals and family members are much more likely to be satisfied with their care, require fewer aggressive medical interventions at the end of life and are more likely to take advantage of hospice resources or die at home.

The National Framework was developed through a national consultative process that included experts in the field, as well as representatives from a number of national professional organizations and non-governmental groups concerned with advance care planning.  The Framework includes an environmental scan as well as key recommendations for implementing advance care planning practices into our health system.

Along with the Framework, the Task Group has launched an awareness campaign – Speak Up: Start the conversation about end of life care – including the proclamation of a National Advance Care Planning Day on April 16. The campaign website (www.advancecareplanning.ca) provides a number of tools and resources for Canadians, community organizations and health care professionals.

“As health care technologies and life saving interventions continue to improve and people live longer – many with complex medical conditions – advance care planning becomes increasingly important,” says Ms. Baxter. “We need to communicate our feelings around the use of certain procedures at the end of life, and what we believe gives our life meaning. These are personal, individual choices that every Canadian deserves at the end of life. Make sure your voice is heard.”


Task Group Team members:
•Sharon Baxter, Canadian Hospice Palliative Care Association
•Shelley Birenbaum, Shelley R. Birenbaum Professional Corporation, Canadian health law expert
•Maryse Bouvette, Bruyère Continuing Care
•Alison Pozzobon, The GlaxoSmithKline Foundation
•Nanci Corrigan, Channel 3 Communications
•Bev Berg, Alberta Health Services
•Darren Fisher, National Lung Health Framework
•Romayne Gallagher, Canadian Society of Palliative Care Physicians / College of Family Physicians of Canada
•Louise Hanvey, Project Manager, Advance Care Planning in Canada, Canadian Hospice Palliative Care Association
•Daren Heyland, Queen’s University, Canadian Researchers at the End of Life Network (CARENET)
•Melody Isinger, Quality End-of-Life Care Coalition
•Larry Librach, University of Toronto, Joint Centre for Bioethics
•Irene Nicoll, Canadian Partnership Against Cancer
•Laurie Anne O’Brien, Canadian Hospice Palliative Care Association Nurses Interest Group and Regional Palliative Care, Eastern Health, NL
•Denise Page, Canadian Cancer Society
•Lonny Rosen, Rosen Sunshine LLP and Canadian Bar Association
•Carolyn M. Tayler, Director, End-of-Life Care, Fraser Health Authority

CHPCA and the Advance Care Planning project appreciate and thank its funding partners, Canadian Partnership Against Cancer and The GlaxoSmithKline Foundation.