Advance Care Planning Checklist Nova Scotia

Most Nova Scotians know they should plan for a time when they cannot make their own healthcare decisions. Far fewer know exactly what that planning requires — and most significantly, how many separate pieces need to work together for the plan to actually function in an emergency.

A signed Personal Directive alone is not enough. Without a Goals of Care form, paramedics will default to full treatment. Without a Green Sleeve, clinical staff may never find your documents. Without a clearly chosen delegate, the statutory hierarchy picks someone for you.

This checklist covers every component that a complete advance care plan in Nova Scotia requires.

Legal Documents

Personal Directive completed. Under the Personal Directives Act (2010), this is the only legally recognized instrument for recording your healthcare and personal care preferences and naming a delegate to act on your behalf. You need the Long Form if you want to include specific treatment instructions; the Short Form only names a delegate.

Enduring Power of Attorney completed. Your Personal Directive handles healthcare. Your Enduring Power of Attorney, under the Powers of Attorney Act, handles finances — bank accounts, property, bills, and investments. Without both documents, at least one domain of your life defaults to either a statutory hierarchy or a court process.

Documents properly witnessed. A Personal Directive needs one independent witness (19+, not the delegate, the delegate's spouse, the person signing on the maker's behalf, or that person's spouse). An Enduring POA needs two independent witnesses present simultaneously (19+, neither can be the attorney, their spouse, partner, or child). Wrong witnesses invalidate the document.

Clinical Documents

Goals of Care (GOC) form completed. This is the medical order that translates your treatment preferences into clinical instructions paramedics and hospital staff can act on. It must be completed by your physician or nurse practitioner — you cannot fill it out yourself. Request a GOC conversation at your next medical appointment.

Expected Death at Home (EDAH) form completed (if applicable). If you have a life-limiting illness and plan to die at home, this form names your chosen funeral home and the physician or nurse practitioner who will complete the Medical Certificate of Death. Without it, your family must call 911, which triggers a police response and potential forensic investigation.

Old DNR/AND forms removed. Nova Scotia Health retired DNR and Allow Natural Death forms on July 23, 2024. If you have old forms in your medical file or Green Sleeve, replace them with a current GOC form.

Delegate Planning

Primary delegate chosen and confirmed. Your delegate must be willing and available, understand your treatment preferences, and be prepared to make difficult decisions under pressure. A delegate who says "yes" out of obligation but is not genuinely prepared may fold under family pressure when the moment arrives.

Alternate delegate(s) named. If your primary delegate is unavailable, unreachable, or unwilling to act, your alternate steps in. Without an alternate, the statutory hierarchy takes over.

No joint delegates. Nova Scotia law prohibits appointing two people to share decision-making authority on the same matter. If you name joint delegates, that section of your directive is invalid.

Delegate conversation completed. Your delegate needs to know your specific wishes — not "just do what's best" but concrete instructions about CPR, ventilators, feeding tubes, dialysis, and comfort care. Have the conversation before you need the document, not after.

Storage and Distribution

Green Sleeve prepared and placed. Your Green Sleeve should contain your signed Personal Directive, your completed GOC form, and (if applicable) your EDAH form. Store it on top of or on the front of the refrigerator. Nova Scotia paramedics check there first.

Copies distributed. Give copies of your Personal Directive to your delegate, alternate delegates, family doctor, and close family members. If you enter a hospital or long-term care facility, request that a copy be placed in your chart.

Digital backup created. Scan your signed Personal Directive and store a high-resolution PDF in a secure cloud folder accessible to your delegate.

Wallet card carried. A card in your wallet or purse stating that you have a Personal Directive, naming your primary delegate, providing their phone number, and noting that your documents are in a Green Sleeve on your refrigerator.

Review Schedule

Review every two to three years. Even if nothing has changed, confirming that your documents still reflect your wishes prevents drift.

Review after major life events. Marriage, divorce or separation (divorce automatically revokes the appointment of a spouse as delegate), a change in your delegate's availability, or a significant change in your health status should all trigger a review and potential update.

Review on facility admission. When entering a hospital or long-term care facility, confirm that your GOC form is validated within the required timeframe (24 hours for acute care, 72 hours for long-term care) and that the facility has a current copy of your Personal Directive.

The Nova Scotia Advance Directive & Living Will Kit provides the complete planning framework — from delegate selection worksheets and treatment instruction templates to Green Sleeve staging guides and document distribution trackers — so nothing falls through the gaps.

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