Health professionals: visit Advanced care planning information for health professionals
There are five steps you can take to begin planning. You don't have to do them all at once. Planning is something you can return to over time.
A Goals of Care designation, often shortened to GCD, is a medical order that describes the general approach to your care: the kinds of treatment that fit your wishes, your preferred location of care, and whether you'd move between care settings. You can also see it as a form in your Green Sleeve.
A designation is written by your most responsible health practitioner, usually a treating doctor or nurse practitioner. It's made with you, by bringing together your values, beliefs, and wishes with your care team's clinical advice. Because it's a medical order, it doesn't require your signature, but it should always come from a conversation with you, or with your decision-maker if you're unable to take part.
Your designation can be reviewed and changed when your health changes, when you move to a new place of care, or whenever you or your decision-maker ask to revisit it.
Learn more about the importance of making your voice heard:
Video: Conversations matterAn advance care planning conversation is a chance to talk about what matters to you, so your wishes are understood before any decisions need to be made. You can start one yourself, and any member of your health care team can help you have it.
You can plan at any time. Some moments make these conversations especially worthwhile:
Ideally, both a personal directive and a Goals of Care designation are in place before you move into a continuing care home, but they are not required beforehand. If they aren't ready, this planning can be done soon after you move in, and an existing designation is reviewed when you arrive to make sure it still reflects your wishes.
Find advanced care planning resources, tools, education, and FAQs to help you guide conversations with confidence.
Information for health professionals
A Green Sleeve is a plastic pocket that holds your important advance care planning documents in one place. It belongs to you, and it's meant to travel with you between home, appointments, and any care setting, so that everyone caring for you can find your wishes quickly.
Any Alberta health care provider can give you a Green Sleeve. You're encouraged to ask your family doctor or another provider for one, and to set aside time to talk through your health care wishes.
At home, keep your Green Sleeve on or near your fridge. Emergency Health Services (paramedics) are trained to look for it there. When you're admitted to care, it's kept at the front of your chart, and it's returned to you when you leave.
Watch this video to learn more about what a Green Sleeve is, and why it’s important for everyone to have one.
Use the following resources to learn more about advance care planning, prepare for important conversations, and make your plan when you’re ready.
The Conversations Matter guidebook provides practical information about Advance Care Planning and encourages ongoing conversations with loved ones and health care providers. The guidebook is available in multiple languages.
Download guidebookImagine a world where health care interactions aren't just about symptoms and treatments, but about connections and understanding. That's the heart of the "What Matters to You?" (WMTY) campaign, which was adopted by Alberta Health Services in 2017.
WMTY is about sparking meaningful conversations between patients, families and those who dedicate themselves to providing care for others.
This video can help you learn more about the risks, benefits, and what could happen from doing cardiopulmonary resuscitation (CPR) and help you decide if it’s right for you.
No. Simply having a personal directive doesn't take away your right to make your own decisions or give any authority to your agent. As long as you're able to make your own decisions, you remain the decision-maker for your care. A personal directive only comes into effect after a capacity assessment finds you're unable to make personal decisions and a decision is needed. Even then, you can still choose to include others in your decisions.
It depends on whether you named someone for this in your personal directive. If you named a person to decide when you've lost capacity, that person does an assessment — most people choose a family member or friend, and it doesn't have to be your agent — and a physician or psychologist also assesses. If you didn't name anyone, two service providers (such as a doctor, nurse, care facility manager, or social worker) each assess, and at least one must be a physician or psychologist. If they conclude you're unable to make personal decisions, your personal directive is brought into effect. It stays in effect until you regain the ability to decide, or until death.
No. A personal directive covers personal and health decisions only — things like medical treatment and where you live. To leave instructions about managing your finances, you need a separate document called an enduring power of attorney.
You don't have to submit your personal directive anywhere for it to be valid — once you and your witness sign it, it's a legal document. If you'd like, you can register it with the Government of Alberta so that your and your agent's contact information is on file. [Link to GoA personal directive registry
Only in specific circumstances, and only if the Public Guardian agrees in advance. The Public Guardian is meant to be a last resort — for when there's no one else able and willing to act as your agent. You'd need the capacity to write a valid personal directive, an understanding of what you're asking, and a willingness to meet with a Public Guardian representative to discuss your wishes, after which they decide whether to accept. You can't name the Public Guardian without consulting them first, and they won't act as an alternate or co-agent. [Link to Office of the Public Guardian and Trustee
Ideally both are in place before you move into a continuing care home, but neither is required beforehand. If they aren't ready, this planning can be done soon after you move in. If you already have a designation, it's reviewed when you arrive to make sure it still reflects your wishes.
Keep your Green Sleeve on or near your fridge at home — emergency medical services personnel know to look for it there. It is meant to travel with you as you move between care providers and care settings, so bring it whenever you receive care. When you are admitted, staff will place it at the front of your chart and return it to you when you leave.
A Personal Directive is only used if you are assessed as unable to make your own personal decisions and a decision is required. On its own, having a Personal Directive does not remove your right to make decisions or give your agent any authority — a specific process must be followed to bring it into effect ("enact" it).
If you named someone to decide whether you have lost capacity, that person does an assessment (it does not have to be your agent), and a physician or psychologist also assesses you. If you did not name anyone, two service providers — such as a doctor, nurse, care facility manager, or social worker, at least one of them a physician or psychologist — each assess you. If they conclude you are unable to make personal decisions, they sign the applicable form, and your agent then has legal authority to make decisions based on your directive. An enacted Personal Directive stays in effect until you regain capacity (which requires a separate assessment) or die.
Keep a copy in your Green Sleeve, and give copies to your agent, your family, and your health care team. Keep the original somewhere safe but accessible. You can also register it with the Government of Alberta, which records contact information for you and your agents.
Yes, but the Public Guardian must agree to it, and this is considered a last resort for when no one else is suitable or willing to act. Under the Personal Directives Act, a directive can name the Public Guardian as agent only if the Public Guardian is the only agent named, you have satisfied the Public Guardian that no one else is able and willing to act, and the Public Guardian consents.
You must have the capacity to write a valid Personal Directive, understand what it means to have the Public Guardian as your decision maker, and be willing to be interviewed by a Public Guardian Representative, who decides whether to accept. You cannot name the Public Guardian without contacting the office first — if you do and later lose capacity, the Public Guardian will decline, and your directive may be considered invalid. The Public Guardian will not act as a co-agent or alternate agent. Contact information is on the Office of the Public Guardian and Trustee website.
