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Advance Care Planning in Canada & Speak Up Logo

OTTAWA, Dec. 13, 2012 (GLOBE NEWSWIRE) -- Dying's not the easiest subject to talk about, but there's a 100% chance that it's going to happen to you. The Speak Up campaign is urging Canadians to stop avoiding the topic by using the holiday season as a time to have an important discussion about our wishes for end of life care.

"Imagine, one day, without any warning, you find yourself in a hospital in a life-threatening situation, unable to communicate," asks Louise Hanvey, the Project Manager for the campaign. " Who would speak for you and make health care decisions on your behalf?"

A March 2012 Ipsos-Reid national poll found that 86% of Canadians have not heard of advance care planning, a process of reflection and communication about personal care preferences.

The poll also found that:

  • less than half have had a discussion with a family member or friend about healthcare treatments if they were ill and unable to communicate
  • only 9% have ever spoken to a healthcare provider about their wishes for care
  • over 80% of Canadians do not have a written plan
  • only 46% have designated a Substitute Decision Maker – someone to speak on their behalf if they could not communicate

Resources to help Canadians make a plan and have conversations, including workbooks, videos and conversation starters, are available at: The campaign has also introduced a cheeky holiday-themed infographic and card to remind Canadians to make their plan and have these important conversations.

"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. Hanvey. "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. This holiday season is the perfect time to start that conversation."

For more information, please contact Vanessa Sherry, Communications Officer, Canadian Hospice Palliative Care Association, 613-241-3663 x229,

The Speak Up campaign is managed by the Canadian Hospice Palliative Care Association (CHPCA), a national, bilingual charitable non-profit association with membership comprised of individuals and hospice palliative care programs and services from every province and territory. CHPCA and the National Advance Care Planning Project appreciate and thank its funding partners, Canadian Partnership Against Cancer and The GlaxoSmithKline Foundation.


  • Research indicates that patients who have end-of-life conversations with their doctors and family members are much more likely to be satisfied with their care, will require fewer aggressive interventions at the end of life, place less of a strain on caregivers and are more likely to take advantage of hospice resources or die at home. ,
  • 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.2
  • A 2010 Canadian study of hospitalized, elderly patients identified that there is a huge unmet need, that providing more support for end-of-life conversations and advance care planning will have a large positive impact on improving end-of-life care in Canada.

What is an advance care plan?

An advance care plan describes your wishes at the end of life, in the event that you cannot speak for yourself. Your plan may include information about your values, goals and preferences for procedures that you do or don't want to have as well as other information about your care at the end of life. The most important aspects of advance care planning are naming one or more Substitute Decision Makers - someone who will speak on your behalf and make decisions for you when you are not able to do so yourself – and having a conversation with them about your wishes. See: for details.

This is a verbal or written summary of a capable adult's wishes or instructions about the kind of care they want or do not want in the event that they cannot speak for themselves. An advance care plan can be written down or simply told to someone who is authorized to speak for the patient, such as a Substitute Decision Maker. It can guide a substitute decision maker if that person is asked by a health care provider to make treatment decisions on behalf of the adult.

Who should make an advance care plan?

Every adult should make a plan. You can't predict how or when you will die – so having a plan ensures that others know your wishes and that your voice will be heard if you cannot speak for yourself.

When is an advance care plan used?

You plan is only used if you are unable to make your own health care decisions (e.g. you are in a coma or your illness has impaired your ability to make decisions). Your representative can use it to guide your care and to express wishes on your behalf.

Wright, AA, et al. Associations between end-of-life discussion, health care expenditures, JAMA, 2008, 300 (14) 1665-1673

Heyland, DK, Allan DE, Rocker G, Dodek P, Pichoa D, Gafni A. Discussing prognosis with patients and their families near the end of life. Impact on satisfaction with end of life care. Open Medicine 2009, 3(20: 71-80

Heyland DK, Cook DJ, Rocker GM, Dodek PM, Kutsogiannis DJ, Skrobik Y, Jiang X, Day AG, Cohen SR. Defining priorities for improving end-of-life care in Canada. Can Med Assoc J 2010;182(16):E747-E752.

A photo accompanying this release is available at:

The Advance Care Planning in Canada & Speak Up logo is available at

The Canadian Hospice Palliative Care Association logo is available at

CONTACT: Vanessa Sherry Communications Officer Canadian Hospice Palliative Care Association 613-241-3663 x229

Source:Canadian Hospice Palliative Care Association