National Ipsos-Reid poll indicates majority of Canadians haven’t talked about their wishes for care


National Ipsos-Reid poll indicates majority of Canadians haven’t talked about their wishes for care

(Ottawa) –Imagine, one day, without any warning, you find yourself in a hospital in a life-threatening situation, unable to communicate.  Who would speak for you and make health care decisions on your behalf? That’s a question that all Canadians need to answer – and a recent poll indicates that most have not.

The March 2012 Ipsos-Reid national poll was conducted to better understand whether Canadians are engaging in advance care planning, a process of reflection and communication about personal care preferences and naming someone to speak for you in the event that you become incapable of consenting to or refusing treatment or other care.

The poll found that:

  • 86% of Canadians have not heard of advance care planning
  • 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% had 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

The population of Fraser Health, British Columbia, which has had a formalized advance care planning program in place since 2005, had more positive results compared to the rest of the country. Residents from this area were more likely to have heard of advance care planning, and were more likely to have discussed healthcare-related decisions with family/friends and healthcare providers.  Other Research has shown that advance care planning significantly reduces stress, depression and anxiety in family members and caregivers.

Resources to help Canadians make a plan and have conversations are available at: April 16th has also been declared National Advance Care Planning Day – a day for Canadians to speak up and start the conversation. The results of the first year of a national multi-year study to examine the impact of advance care planning on elderly patients and their families (the ACCEPT study) will be released on that day in Calgary, Alberta.

“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 Sharon Baxter, Executive Director of the Canadian Hospice Palliative Care Association (CHPCA) and a member of the Advance Care Planning National Task Group. “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. April 16th – National Advance Care Planning Day – is the perfect time to start that conversation.”

For more information: contact Vanessa Sherry, Communications Officer, Canadian Hospice Palliative Care Association, 613-241-3663 x229, [email protected].

The Ipsos-Reid poll was conducted with funding support from the Canadian Researchers at the End of Life Network and Fraser Health. 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.

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.

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

[1] 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

[1] 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.