
Advance Serious Illness Planning on Paper
Available in French and English, for individual use and for ordering in bulk from print shops.
The last 4 pages serve as the Dear Doctor Letter.

The additional resources listed below can help you think more about your values and preferences and provide you with more information about medical treatments and medical decision-making.
Available in French and English, for individual use and for ordering in bulk from print shops.
The last 4 pages serve as the Dear Doctor Letter.
Cardiopulmonary resuscitation: let’s be ready to talk about it!
La réanimation cardiorespiratoire : soyons prêts à en parler!
Much focus and attention is given to patients, rightfully so, however caregivers play an integral role in an illness journey. These resources have been compiled to offer supports and tools to empower a caregiver in their important role.
Inspired by our own caregiving journey, we’ve created this free handbook to help you be more prepared for the task at hand, feel more yourself, and reduce your stress. We have also included 15+ worksheets and resource lists to give you the essential tools to support you in your role as caregiver.
Included in the guide:
+ many more tools and resources to help you along the way.
Dr. Daren Heyland and colleagues have been scientifically validating the Plan Well system in clinical settings for over 20 years. The Guides you see today are the culmination of those years of research. To read more about how we got here and how our Guide was developed, feel free to browse through our publications:
We published an article in the journal Health Expectations detailing the process of English to French translation and cultural adaptation of the Plan Well Guide.
Randomised trial of a serious illness decision aid (Plan Well Guide) for patients and their Representatives to improve engagement in advance care planning.
In a post-hoc subgroup analysis, there was a significant difference in favour of the Plan Well Guide group in participants with a lower-than-median baseline score compared with those at or above the median. The use of Plan Well Guide led to a significant improvement among Representative (formerly called Substitute Decision Makers) who were the least prepared at the start.
A randomized trial of Plan Well Guide was recently published in CMAJ Open. The results showed that Plan Well Guide improves decision quality, patient and physician satisfaction, and reduces time physicians spend on their interactions with patients.
The Health Education Journal recently published findings from the Preparedness for the Future survey. The purpose of this paper is to describe people’s general state of preparedness for their future as older persons, identify specific attitudes towards ageing and key characteristics that portend a lesser degree of preparedness, and identify the issues that need greater emphasis. The findings show that people’s attitudes towards their future self as an older person are related to their state of future preparedness and may have an impact on their future health and well-being.
March 25
Journal of Palliative Medicine: Caught in a Loop with Advance Care Planning and Advance Directives: How to Move Forward? Experts in advance care planning discuss the problems associated with traditional advance care planning and deliberate embracing our new approach ‘advance serious illness planning’!
June 30
BMJ Supportive & Palliative Care: Randomised trial of a serious illness decision aid (Plan Well Guide) for patients and their substitute decision-makers to improve engagement in advance care planning
March 13
Aging Clinical and Experimental Research (2021): Challenges and facilitators in delivering optimal care at the End of Life for older patients: a scoping review on the clinicians’ perspective
February 2
Journal of General Internal Medicine (2021): Randomized Controlled Trial of a Decision Support Intervention About Cardiopulmonary Resuscitation for Hospitalized Patients Who Have a High Risk of Death
November 25
Patient Education and Counseling, Volume 104 – Issue 4: Effect of “Speak Up” educational tools to engage patients in advance care planning in outpatient healthcare settings: A prospective before-after study
September 23
MedRxiv Preprint: Supporting decision-making on allocation of ICU beds and ventilators in pandemics
September 17
ICU Management & Practice, Volume 20 – Issue 3: Unmasking the Triumphs, Tragedies, and Opportunities of the COVID-19 Pandemic
September 1
Australian Critical Care, Volume 33 – Issue 5: Shared decision-making in the intensive care unit requires more frequent and high-quality communication: A research critique
August 11
The Royal College of Physicians and Surgeons of Canada: New tool helps patients plan for serious illness care
July 18
Healthcare, MDPI, Volume 8 – Issue 3: Advance Care Planning (ACP) vs. Advance Serious Illness Preparations and Planning (ASIPP)
July 10
Ontario Hospital Association: Supporting Patients in Getting the Medical Care that Is Right for Them
June 3
Canadian Geriatrics Journal, Volume 23 – Number 2: The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care
June 1
Canadian Medical Protective Association Practically Speaking Podcast: COVID-19: Advance care directives
May 25
BMC Family Practice, Volume 21- Number 94: Exploring patient-reported barriers to advance care planning in family practice
May 21
Canadian Hospice Palliative Care Association: Become a CHPCA Associate or Affiliate / Provincial Member
May 1
Canadian Geriatrics Journal, Volume 23 – Issue 2: The Impact of Prior Advance Care Planning Documentation on End-of-Life Care Provision in Long-Term Care
Journal of Post-Acute and Long-term Care Medicine, Volume 21 – Issue 5: A Multicenter Study to Identify Clinician Barriers to Participating in Goals of Care Discussions in Long-Term Care
April 28
Canadian Medical Association Journal, Volume 8 – Issue 2: A novel decision aid to help plan for serious illness: a multisite randomized trial
March 2020
The Annals of Family Medicine, Volume 18 – Issue 2: Effect of an Interactive Website to Engage Patients in Advance Care Planning in Outpatient Settings
March 25
Family Practice, Volume 37 – Issue 2: Primary care clinicians’ confidence, willingness participation and perceptions of roles in advance care planning discussions with patients: a multi-site survey
January 19
The Lancet: EClinicalMedicine, Volume 19: Advance care planning; we need to do it more, but it needs to be done differently
December 1
Journal of Pain and Symptom Management, Volume 58 – Issue 6: Brief English and Spanish Survey Detects Change in Response to Advance Care Planning Interventions
October 28
Journal of Post-Acute and Long-Term Care Medicine, Volume 21 – Issue 5: A Multicenter Study to Identify Clinician Barriers to Participating in Goals of Care Discussions in Long-Term Care
October 25
Canadian Medical Association Journal, Volume 7 – Issue 4: Supporting shared decision-making about cardiopulmonary resuscitation using a video-based decision-support intervention in a hospital setting: a multisite before–after pilot study
September 20
June 1
BMJ Supportive & Palliative Care: Evidence of increasing public participation in advance care planning: a comparison of polls in Alberta between 2007 and 2013
May 1
Journal of Pain and Symptom Management, Volume 57 – Issue 5: Adaptation and Preliminary Validation of the Advance Care Planning Engagement Survey for Surrogate Decision Makers
March 1
BMJ Supportive & Palliative Care: Patient-family agreement on values and preferences for life-sustaining treatment: results of a multicentre observational study
February 6
BMJ Supportive & Palliative Care Published Online First: Short Graphic Values History Tool for decision making during serious illness
February 1, 2018
Journal of Pain and Symptom Management, Volume 55 – Issue 2: Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus
January 1, 2018
Journal of Pain and Symptom Management, Volume 55 – Issue 1: Development and Psychometric Properties of a Survey to Assess Barriers to Implementing Advance Care Planning in Primary Care
December 6, 2017
BMC Medical Informatics and Decision Making, Volume 17 – Number 164: Recognizing difficult trade-offs: values and treatment preferences for end-of-life care in a multi-site survey of adult patients in family practices
November 1, 2017
Journal of Cardiac Failure, Volume 23 – Issue 11: Barriers to Goals of Care Discussions With Patients Who Have Advanced Heart Failure: Results of a Multicenter Survey of Hospital-Based Cardiology Clinicians
September 1, 2017
BMJ Supportive & Palliative Care: Discordance between patients’ stated values and treatment preferences for end-of-life care: results of a multicentre survey
The Lancet: Oncology, Volume 18 – Issue 9: Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care
July 31, 2017
Canadian Medical Association Journal, Volume 189 – Issue 30: Validation of quality indicators for end-of-life communication: results of a multicentre survey
June, 2017
Journal of Critical Care, Volume 39: Development and initial evaluation of an online decision support tool for families of patients with critical illness: A multicenter pilot study
May 1, 2017
Journal of Pain and Symptom Management, Volume 53 – Issue 5: Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel
April 1, 2017
Journal of Pain and Symptom Management, Volume 53 – Issue 4: Measuring Advance Care Planning: Optimizing the Advance Care Planning Engagement Survey
September, 2016
Critical Care Medicine, Volume 44 – Issue 9: Predicting Performance Status 1 Year After Critical Illness in Patients 80 Years or Older: Development of a Multivariable Clinical Prediction Model
August 17, 2016
BMJ Quality & Safety: The prevalence of medical error related to end-of-life communication in Canadian hospitals: results of a multicentre observational study
April, 2015
JAMA Intern Medicine, Volume 175 – Issue 4: Barriers to Goals of Care Discussions With Seriously Ill Hospitalized Patients and Their Families: A Multicenter Survey of Clinicians