Advance Care Planning is a process of reflection and communication. It is a time for you to reflect on your values and wishes, and to let people know what kind of health and personal care you would want in the future if you were unable to speak for yourself to consent to or to refuse treatment or other care. 

The Nova Scotia Hospice Palliative Care Association is pleased to provide a series of resources to assist with Advance Care Planning process. It is recommended that in addition to reviewing and or utilizing some of the resources below that you discuss the process with those close to you, your medical professional and/or legal professional to ensure that you have the supports needed for your specific situation. 

Getting started

Steps to make your plan



Think about what is right for you.

Begin by reflecting on your values, beliefs and understanding about end-of-life care or specific medical procedures, such as drug therapies, cardiopulmonary resuscitation (CPR) or dialysis. Think about any situations that you may have experienced with others and how it made you feel. You should also speak with your health care providers to ensure you have accurate information about your own health condition in order to express wishes about medical procedures that you may or may not want. 

Ask yourself: 

  • If possible, would I prefer to die at home, in a hospital or in a long term care facility? 
  • What might change my mind about my choice? 
  • Do I want or not want certain medical interventions (e.g., resuscitation or feeding tubes) if I am unlikely to survive or live independently?
  • Why would I want or not want these procedures?
  • Do I have any fears about dying (e.g., I’ll be in pain, I won’t be able to breathe)? 
  • Is there someone that I can talk to about these fears, such as my doctor?
  • What would be meaningful for me at the time of my death (e.g., family/friends nearby, music playing or pictures)?



Learn about end-of-life care options and procedures.

Some individuals want to prolong life as long as possible using medical interventions. Others would not want to be hooked up to machines at the end of life if there is no chance of recovery. 

There are terms and phrases often used at end of life and other times of significant illness. It will be helpful to review these terms as a first step in thinking about what is right for you.



Decide who will make medical decisions on your behalf should you become incapable of doing so.

Think carefully about who you feel would understand, honour and follow your wishes, and would be most capable of making medical decisions on your behalf as your Substitute Decision Maker. This may be a spouse, an adult child, a trusted family member or a good friend. Your Substitute Decision Maker should be someone who knows you very well and who you can trust. They must be willing to respect your views and values and act on your wishes, not their own. And they should be able to make difficult decisions in stressful situations. 

Before you choose someone, you need to understand what the law says about what you must do to appoint someone as your Substitute Decision Maker. You also need to know what happens if you do not appoint someone to act for you through that legal process. 

In Nova Scotia, the Personal Directives Act provides a framework for choosing a Substitute Decision Maker, known as a Delegate, and for completing a written document outlining your health and personal care wishes. This document is called a Personal Directive. 

Your Personal Directive may: 

  • Name your Substitute Decision Maker. 
  • Provide written instructions about your wishes for care. 
  • Do both of these things. 


Begin conversation

Now that you have information about Personal Directives and Substitute Decision Makers/Delegates in Nova Scotia, it’s time to have a conversation with those who may make decisions for you, your family, and, if needed, appropriate health care professionals.  

It is important to know that making a Personal Directive is one part of the planning process. Having conversations and ensuring those closest to you know your wishes, values and beliefs regarding your health and quality of life is critical and will help shape your Personal Directive and help others make decisions for you.  

Your future Delegates or Statutory Decision Makers may find the conversation difficult, or they may be relieved to know exactly what kind of care you would like to receive.



Document your wishes in your Personal Directive.  

In Nova Scotia, written documentation of your health and personal care wishes is known as a Personal Directive. Personal Directives can consist of simply naming a Delegate who will make decisions for you, or you may wish to provide instructions about relevant health and personal care scenarios that are important to you. These written instructions can be very detailed or they can speak more broadly to your wishes and values regarding your health, personal care and quality of life. 

If you do decide to put written instructions in a Personal Directive, make sure that your future Delegates have a copy of your document, and that they can understand it, honour it and feel comfortable making medical and other personal care decisions on your behalf. 

Do not forget to tell others too, such as your doctor, other health care professionals involved in your care, your lawyer, and other family members or friends. Let your doctor know who you have appointed to be your future Delegate and that you have shared your wishes, goals and values with them. You may wish to provide your Personal Directive to your doctor or request that the information be noted in your medical record. This is important so that if you become mentally incapable, your doctor can discuss your wishes about health care with your delegate or if relevant, the person appointed as Statutory Decision Maker. 

Featured Resource

Advance Care Planning Workbook

The Advance Care Planning Workbook is a general guide that helps you understand what is involved in advance care planning, provides useful definitions, tips and can be used as a first step in the advance care planning process.

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