Advance Care Planning Checklist PEI

Advance care planning in PEI involves more documents, more decision-makers, and more distribution steps than most people expect. The province's two-statute framework means you can't just fill out one form and call it done — and even a complete set of documents is only useful if the right people have copies and the clinical records are updated.

This checklist walks through the entire process in order, from initial decisions through clinical registration.

Part 1: Clarify Your Decisions

Before touching any paperwork, sort out three questions:

What medical treatments do you accept or refuse? Think in specifics, not generalities. Health PEI uses three Goals of Care designations: R (all interventions including resuscitation), M (active medical treatment but no resuscitation), and C (comfort care only). Deciding which designation matches your values now saves confusion when you sit down with your doctor.

Who should make medical decisions if you can't? This person becomes your Proxy under the Consent to Treatment and Health Care Directives Act. They need to be at least 16, willing to accept the role formally, and ideally close enough to reach a PEI hospital quickly.

Who should handle non-medical personal decisions? Housing, nutrition, daily care routines, and social activities fall under a Personal Directive. The person you appoint is your Agent — a different role from your Proxy, governed by a different statute. You can appoint the same person for both roles, but the authority comes from separate documents.

Part 2: Create the Documents

• [ ] Health Care Directive — Write your treatment preferences using R/M/C language. Name your proxy and alternates. Include your Personal Health Number, the date, and your signature.
• [ ] Proxy acceptance signatures — Each named proxy and alternate must physically sign the Health Care Directive to accept. This is mandatory under PEI law; an unsigned proxy appointment is legally invalid.
• [ ] Personal Directive — If you want someone to handle non-medical personal decisions (housing, nutrition, social activities), create a separate Personal Directive naming your Agent. You and one witness must sign in each other's presence.
• [ ] Enduring Power of Attorney — For financial and property management, create this document naming your Attorney. You and one witness must sign in each other's presence. Under Section 37 of the Powers of Attorney and Personal Directives Act, you can combine the Personal Directive and Power of Attorney into a single document — but the Health Care Directive must remain separate.

Part 3: Get Clinical Registration

• [ ] Hand-deliver the Health Care Directive to your family physician or nurse practitioner. Ask them to scan it into your clinical EMR file.
• [ ] Schedule a Goals of Care conversation with your physician. They'll review your treatment preferences and write a formal Goals of Care Designation (GCD) medical order — R, M, or C — on the official Health PEI form.
• [ ] Confirm the GCD is saved to the provincial Electronic Medical Record. This makes your treatment order accessible to any Health PEI facility, including emergency responders.

Part 4: Distribute Copies

• [ ] Proxy and alternates — Give each named proxy a copy of the signed, accepted Health Care Directive. They need it accessible, not in a filing cabinet.
• [ ] Agent and Attorney — If you created a Personal Directive and Power of Attorney, give copies to those representatives as well.
• [ ] Immediate family members — Even though only your proxy has legal authority over medical decisions, informing family that the directive exists (and that it's registered clinically) prevents disputes during a crisis.
• [ ] Home copy — Place a copy in a clear plastic sleeve on your refrigerator or another visible, unlocked location. Emergency first responders are trained to look for these.
• [ ] Health PEI Advance Care Planning wallet card — Complete this card and carry it at all times. It tells emergency responders you have a directive and provides proxy contact information.

Part 5: Organ Donation

PEI has no automated digital organ donation registry. If organ donation matters to you, cover all three registration pathways:

• [ ] Health card sticker — Request the red organ donor sticker from Health PEI (mailed with your health card renewal).
• [ ] Driver's license symbol — Have the red heart engraved on your license during your next in-person renewal at Access PEI.
• [ ] Written instructions — Include explicit organ donation wishes in your Health Care Directive. Without this written record, hospital staff may ask your family, who might not know your preferences or might disagree.

Part 6: Review Schedule

• [ ] Set a biennial review date — PEI health care directives don't expire, but a review every two years catches outdated proxy appointments, treatment preferences that no longer match your health situation, and changes in family dynamics.
• [ ] Trigger-based reviews — Update immediately after any major life change: new diagnosis, marriage, divorce, death of a proxy, relocation of a proxy, or a shift in your treatment philosophy. Replace all distributed copies and update the clinical EMR and GCD.

What This Checklist Doesn't Cover

This checklist addresses the planning documents and clinical registration. It doesn't cover a Last Will and Testament (which directs asset distribution after death) or the estate administration process (probate, executor duties, final tax returns). Those are separate processes that activate only after death — the documents above are for decisions during your lifetime.

For a comprehensive version of this checklist with pre-formatted signature blocks, the Goals of Care Translation Worksheet, a Coordination Checklist that ties all three documents together, and a Storage and Distribution Log, see the Prince Edward Island Advance Directive & Living Will Kit.

See more Prince Edward Island guides →