Advance Serious Illness Planning

By failing to plan, you are planning to fail!

What is Advance Serious Illness Planning? (ASIP)

Advance Serious Illness Planning is putting your values, goals and preferences into a document, so when you are ill and can no longer make decisions, your doctors, substitute decision-maker and your family can refer to it.

Serious illness, like COVID-19 pneumonia, can happen at any time. Likely you will be so sick that you are unable to communicate but there will be important medical decisions that need to be made about the care you receive. The doctors will look to your family members for help in making these decisions that have life and death consequences. Who would speak for you? And do they know what your values and preferences are? If they don’t know your values and preferences, they will suffer tremendous stress and anxiety and you may not get the medical care that is right for you. The sad reality is that in hospitals today, lots of medical errors happen where people are getting the wrong medical care, adding to suffering and distress.

By planning your medical care in advance and sharing information with your family members, you can significantly reduce their stress and anxiety when they are called upon to make decisions for you. And, you are more likely to get the medical care that is right for you!

A page out of our
ASIP Workbook

Plan Well Guide’s FREE ASIP Workbook

We have created an online course that will walk you through creating your Advance Serious Illness Plan. You will

  1. Be educated about the different types of medical care and treatments
  2. Be able to express your values and goals
  3. Get done-for-you documents to allow for easy sharing and communication

Our workbook is designed to help you make informed decisions about your medical care. We don’t want to overload you with information, therefore the workbook will always save your progress and you can pick up where you left off as many times as needed.

What We'll Cover

The workbook is divided into 6 sections. Here is an overview of each one:

  1. Serious Illness Decision Making
    • provides an overview of serious illness and why planning is important.
  2. Thinking about your values & preferences
    • guides you through a self-reflection process to understand your values.
  3. Different Types of Care
    • goes over the different types of medical care that you would choose between if you were seriously ill.
  4. Finalizing My Medical Preferences
    • reviews your values and preferences after having learned about medical care and allows you to make any necessary changes.
  5. Incapacitated State
    • helps you plan for your everyday life and personal care (non-medical) if you survived your serious illness and end up in a state where you cannot think for yourself.
  6. Substitute Decision Making
    • goes over the role of a substitute decision-maker (SDM) and how to choose someone to be your SDM.

Why Make An Advance Serious Illness Plan?

Failing to plan could lead to undesirable outcomes such as:

  • dying an undignified, uncomfortable death as a result of unwanted life-saving measures
  • being allowed to die when you would have rather lived
  • family disagreement and conflict
  • stress on your family members and loved ones
  • anxiety and guilt for the decision makers, wondering if they made the right call
This Matters

Common Misconceptions About Advance Serious Illness Planning

You don’t have to be sick to plan for a future serious illness. Serious illness or another medical crisis can start at any time. The best time to do serious illness planning is when you’re well, just like fixing a leaking roof. The best time to fix it is when it’s not raining.

I don't want to think about death and dying.

We understand your angst to confront your own mortality. But we are not doing end of life planning. This is planning for serious illness, for future periods of incapacitation due to illness or injury. Even though this is difficult to think about, it will save you and your family stress in the future. By failing to plan, you increase the risk of receiving the wrong care, giving rise to family conflict, and putting feelings of anxiety and guilt on your family members.

Advance Serious Illness Planning is not important

Yes it is. As much as we trust our family and the healthcare system to take care of us, there is a high rate of medical error (66%). Only 1 out of 3 patients gets the medical treatment that is right for them. Planning for serious illness in advance increases the likelihood that you will receive the care that you want and need for a high quality of life.

Why doesn't my doctor bring it up

Doctors believe it is important and are equally frustrated with the situation. They say their biggest barrier to talking to their patients is their belief that the patient and/or family don’t want to talk about this or aren’t prepared for the discussion. You can make it easier on your doctor by going through the planning process and presenting them with a copy of your ‘Dear Doctor’ letter. They will love it!

My family will do right by me

Your family may know you well. But they don’t know you well enough to know exactly what to do when called upon to make life and death decisions on your behalf. Consequently, they will experience significant stress and anxiety if you don’t know your values and preferences. Give them a copy of your plan, and they will thank you for it.

I trust the system

Current audits of decision-making in hospitals show a medical error rate of 66%. That’s a 1/3 chance of getting it right if you rely on the system to ‘guess’ what’s right for you.

I've already done this with my lawyer

How sensible is it that you do your health planning with a lawyer? We are trying to change legal practice and get them out of the health planning business. Their health planning practices are not helpful to you or your future doctors.

People who engage in advance serious illness planning:

  • Reported a greater sense of control over their health care,
  • Reported improved communication between them, their family members and their clinicians, and
  • Reported increased satisfaction with their medical care they receive.
  • Were much more likely to get medical care that was consistent with their values and preferences.

Also, advance medical care planning was shown to reduce the burden and conflict among loved ones and reduced stress, anxiety and depression in surviving family membersi.

[i] McMahan, Ryan D., et al. Deconstructing the Complexities of Advance Care Planning Outcomes: What Do We Know and Where Do We Go? A Scoping Review. 7 Sept. 2020,

How to Make Hard Conversations Easier

Oftentimes, family members can have a very difficult time helping out with decision-making during a stressful time like an illness or injury if they haven’t discussed it with you before. We know that these topics can be difficult to discuss — but they are important.

Please invite your family members to watch the Conversations video to help you get started.