Advance Serious Illness Planning – how does this fit into an estate plan?

At LegalWills.ca we provide the tools for all key “estate planning” documents. These include a Last Will and Testament, Financial Power of Attorney, and “Living Will”. According to leading medical practitioners, one key document is missing – a document that describes the medical treatment you wish to receive if you have a serious illness. Not an “end-of-life” document, Advance Serious Illness Planning. We met with Dr Daren Heyland of Queens University. He has created the Plan Well Guide, and kindly agreed to write a guest article for us.

Dr. Daren K. Heyland, MD, MSc, FRCPC

Advance Serious Illness Planning (ASIP): A conversation with a critical care doctor

Why Should I do My ASIP ASAP?

As a critical care doctor, it was my lived experience that people arrive knocking on the doors of the Intensive Care Unit were ‘ill-prepared’ to make big life and death decisions regarding their medical care when they were seriously ill. I suppose you could consider that who ever could be prepared for that event? But the realities of COVID-19 have taught us all that we need to be ready to face the reality of such decisions- if not us personally, certainly the older people in our family circles. Importantly, over 20 years of research confirm that for people who think ahead and plan ahead for their medical care when they are seriously ill, they will have a better illness experience. They are more likely to get the medical care that is right for them and their families, an in particular, the substitute decision-maker, will experience less stress and anxiety when they are co-opted into helping make these life and death decisions on behalf of the sick patient.

I strongly advocate that people ‘think ahead and plan ahead’ for their serious illness. You may…

  • have already thought and talked about your wishes for care at the end of your life or terminal care and,
  • feel that advance care planning is not important because you are not sick or close to the end of your life.

This is not that. This is different.

At the point when you experience a serious illness, doctors will need to know whether to apply life – sustaining treatments and they won’t know for sure if you are dying- so end of life plans don’t apply. We are talking about ‘advance serious illness planning.’

What is serious illness?

Serious illness is the kind of medical condition that requires you to be hospitalized, like a bad COVID-19 pneumonia, a serious motor vehicle accident, advanced cancer, or a major heart attack. You are so sick that you may die, but there is also a chance that you may recover. Please note, serious illness can strike at any time, to anyone. Catching COVID-19, crossing the street and getting hit by a car, or an unexpected heart attack can come at any moment. Will you be ready to make life and death decisions?

Credit: Pexels

What Does Serious Illness Planning Look Like?

With serious illness planning, we don’t advocate you make decisions in advance. Rather, we suggest you educate yourself on how medical decisions are going to be made when you are sick (see image). At that point when you become seriously ill, a doctor will try to speak to you and explain what is going on and how they might treat you. It may be your family doctor or more likely it will be an Emergency Room (ER) or Intensive Care Unit (ICU) doctor that you’ve never met before. But they will want to know your values and preferences so they can help make the decision that’s right for you.

Advance serious Illness Planning
What does Serious Illness Planning look like?

Realize that as with many things in life, we don’t always get exactly what we may want or wish for. This principle applies to serious illness planning, because the medical treatments you receive depend on a variety of factors that include, but are not limited to…

• your illness,

• your doctor’s recommendations,

• how you are doing your prognosis

• and your values and preferences

We know from our research that people don’t know how to express their authentic values in a way that is meaningful to doctors and are not adequately informed about the risks, benefits, and possible outcomes of different treatments available when seriously ill. That’s why we developed Plan Well Guide!

What is Plan Well Guide?

Plan Well Guide is a free, online, virtually guided serious illness planning tool. Our goal with Plan Well Guide is to help you prepare a plan that clearly communicates your values and preferences that you can take to your doctor and share with your loved ones and substitute decision-maker, a person you have chosen to make healthcare decisions for you if you were not able to. We have shown that patients who do serious illness planning are more likely to get the medical treatments that are right for them and their substitute decision-makers are better prepared to help you get the medical care that’s right for them. We invite you to learn more about serious illness planning at www.planwellguide.com

Wait! Haven’t I Already Done My Advance Health Planning with the Living Will service at LegalWills.ca?

Frequently, I have a conversation with someone about the importance of advance serious illness planning and the person responds back to me, “Oh, I’ve done that. I’ve written my Living Will and filled out those forms” Somehow, people feel like doing medical planning as part of an estate plan is an appropriate thing to do! To me, this doesn’t make much sense. Would it be appropriate for me to go into a court room and ‘try a case’

At this point, I am very pleased to announce a collaboration with Legalwills.ca! At the same time where they continue to offer inexpensive, accessible online legal planning services, they will emphasize to their clients the importance of serious illness planning (along with their other traditional offerings) and direct them to Plan Well Guide for their serious illness planning. They help us ‘get the word out’, we help them provide a better service to their clients.

What’s the point in doing this advance medical planning? The planning documents are never available when you and where you need them!


Good point! This is one of the barriers that keeps people from engaging in planning in advance. We understand that and feel like we have solved this problem through our partnership with Legalwills.ca.  Let me explain. The output of the Plan Well Guide planning process is what we call a ‘Dear Doctor’ letter. This downloadable and shareable document is a summary of your planning process. It records your values, preferences, other comments, and outstanding questions or issues in writing. It serves as a script for you or your substitute decision-maker when you engage a doctor in the future when you are seriously ill. Legalwills.ca offers an online, secure storage facility so you can keep your “Dear Doctor” letter along with your other legal planning documents in a secure cloud repository. These planning documents can be accessed by yourself or trusted advisors when and wherever needed. By partnering with LegalWills.ca we’ve reduced the barriers to advance serious illness planning!

Please do your ASIP ASAP. You can then have ‘peace of mind’ that you are more likely to get the medical care that is right for you. And your family with thank you because they will be less stressed when they need to represent your wishes in these important life and death decisions.

Thanks in advance for listening. Stay well!

Daren Heyland
Critical Care Doctor
Creator of Plan Well Guide

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