Health-care decisions in the hospital

Some of the most complex decisions are whether to use life support or life-prolonging medical interventions, such as a ventilator, tube feeding, kidney dialysis, or CPR to restart the heart and lungs. The health care provider will offer these treatments when they believe they are medically appropriate.

Advance care planning gives you a say about the health care you would like to receive as a patient if you get very sick and cannot speak for yourself. It's a way to reflect on the values most important to you, and to discuss your wishes with those close to you to make future health care decisions.

Adults who can make their own health care decisions – especially those with chronic or complex health conditions – are encouraged to start the advance care planning process. If your loved one can’t make their own decisions, you must appoint a substitute decision-maker.

An advance care plan can address different situations, such as your hospital care during and after routine surgery, care in the event of an accident, or end-of-life care decisions.

We know access to information is one of a family’s most essential needs. Having a family spokesperson is very important. A spokesperson is one person who will act as the point of contact for friends and family. This person can speak with the doctor or nurse about the patient’s condition and is responsible for relaying these updates to family and friends. A spokesperson is different than the Temporary Substitute Decision Maker (TSDM), as the spokesperson can only relay information to family members. They cannot make any medical decisions for the patient unless they are also the TSDM.

Role of the spokesperson

• Be the primary person to communicate with the health care team about the patient’s condition and care plan
• Coordinate visitations and relay information with extended family and friends 
• Update family and friends regularly 

Sometimes, your loved one cannot make decisions about their care. In these cases, a temporary substitute decision-maker (TSDM) may be needed to make necessary legal decisions on behalf of the patient.

When a person is unconscious or critically ill and cannot make medical decisions for themselves, a TSDM is identified, as outlined by the Health Care Consent Act. This is different than the spokesperson. *For more information on the Health Care Consent Act, please review the Consent to Health Care Pamphlet. 

The TSDM is responsible for signing for medical procedures, providing additional information to the doctors and nurses and advocating for the patient’s care wishes. 

Periodic progress reports will be given to the spokesperson/or the TSDM by one of the doctors or nurses. Formal, sit-down family meetings will be arranged as needed or upon your request. If you wish to meet with any other health care team member, please just ask. 

The spokesperson for your family can call for an update, but please be mindful that the bedside nurse who provides telephone updates may be providing hands-on care at the time of your call. When this happens, you may be asked to call back at a later time.