Chances are that you have heard the words, “advance care planning” (ACP). However, what exactly do they mean?  Advance care planning is a way to help you think about, talk about, and document your wishes for healthcare. It’s a process that can help you make healthcare decisions now and for the future.

Recent studies show that only 2 out of every 10 Canadians know what ACP is. In Alberta, studies show that we are doing some parts of advance care planning:

• 60% of Albertans have discussed treatment wishes with family
• 20% of Albertans have discussed treatment wishes with a clinician. (1)

My first ACP experience was a situation where it would have been extremely beneficial but it was painfully absent.  When my father was diagnosed with an aggressive brain tumor immediate surgery was done.  After the surgery, Dad never again talked, walked or ate.   His death came three short weeks later.  As a family, we had to make critical health care decisions on his behalf.  We made these decisions in a vacuum.  We made our best guess about what Dad would have wanted if he had been able to speak for himself.

I am comforted by the fact that this won’t happen if we face a similar situation with my Mom.  We have had ACP conversations through the years to learn about her wishes.  As her life shifts, we review her wishes given these changes.  When Mom recently moved into a Seniors’ Residence, she immediately checked to make sure her ACP documents were again located near her fridge.  As a family, we know the value of advance care plans.  We see them as a loving gift that we give each other even if the conversations are difficult.

Most of us recognize the importance of these ACP conversations.  But, we find it hard to start them.  If feels awkward to talk about the ‘what if’s’ with family members and our health care providers.  We know we won’t live forever but conversations that acknowledge this feel uncomfortable.  It is easier to avoid or postpone them.

How about choosing to make Valentine’s Day 2017 your day to be bold, stop procrastinating and initiate an ACP conversation?  It well might be one of the most loving acts that you ever share with your loved one.

The best place to start might be to think about your own wishes should you be the one unable to speak for yourself.  What would matter most to you?  What makes a day worthwhile for you?  Think about who might be the best ‘substitute decision-maker for you’?  Give them your ‘Valentine’s gift’.  Talk to them.  Tell them this is like getting an insurance plan.  It is putting something in place ‘just in case’ you should be unexpectedly unable to make decisions for yourself.

After thinking and talking about your own wishes, you will likely be more comfortable exploring these questions with others.  One of these phrases might be helpful:

• “I wonder if you ever think about health care decisions and what might happen if you were in a situation where you couldn’t speak for yourself.”
• Tell them my family story and then say, “At times I worry that something unexpected might happen to you. If I had to make health care decisions for you, I’m not sure I would know what you would want me to decide.  Can we talk together about that?”.
• “Who would you want to be your health care decision maker if for some reason you couldn’t speak for yourself? Have you ever talked with that person so they know what you would want?

This Valentine’s Day be bold AND loving.  Start an ACP conversation with someone you love.  Once you get started, the conversation can continue over time.  Your courage and love have the potential to make an incredible difference in the life of someone you love AND in your life.   In time you will look back and recognize your ‘gift of love’.

You can find more conversation starters and resources on the websites below.

• http://www.albertahealthservices.ca/info/page12585.aspx (Alberta resources)
• http://www.advancecareplanning.ca/resource/conversation-starters/ (Canadian Resources)
• http://theconversationproject.org/wp-content/uploads/2016/09/TCP_NEWStarterKit_Writable_Sept2016_FINAL.pdf

(1)  http://www.acpcrio.org/files/acpcrio/acp-crio-infographic-scn-generic-15aug2016.pdf

Bert Enns

Bert Enns is a pioneer in Advance Care Planning work.  In 2005, she led the AHS Calgary team who developed the initial resources in Alberta for advance care planning and the Goals of Care framework used in health care settings.  The team co-hosted the first Canadian Symposium on ACP in Calgary.  Bert was a member of the National Advisory Committee that developed the ‘Speak Up’ resources for all Canadians.  She continues to be a passionate advocate for ACP conversations for families and with the health care teams.