Advance Care Planning Checklist for Northwest Territories

Your NWT Advance Care Planning Checklist

Advance care planning in the Northwest Territories involves more than signing a single form. The territory's unique geography, limited legal services, and cross-border healthcare pathways mean that a complete plan requires careful attention to details that residents of southern Canada never have to think about.

This checklist walks through every step, from initial reflection through document execution and distribution.

Phase 1: Reflect on Your Values and Preferences

Before drafting any documents, spend time thinking through what matters to you:

• Treatment preferences. Under what conditions would you want life-sustaining treatment continued? When would you want it stopped? Think specifically about CPR, mechanical ventilation, tube feeding, and dialysis.
• Quality of life thresholds. What would an unacceptable quality of life look like for you? Permanent unconsciousness? Severe cognitive impairment? Inability to communicate?
• Residential preferences. If you can no longer live independently, where would you want to receive care? At home with support? In a long-term care facility? In Yellowknife, closer to medical services? Or in your home community, close to family and land?
• Cultural and spiritual considerations. Do your beliefs influence your medical decisions? Are there specific practices or rituals you want honoured during end-of-life care?
• Pain management priorities. Is your priority maximum alertness, or maximum comfort even if it reduces consciousness?

Phase 2: Choose Your Decision-Makers

• Select a primary Agent for your Personal Directive (healthcare and personal decisions). They must be at least 19 and willing to follow your instructions, even under pressure.
• Select an alternate Agent in case your primary Agent is unavailable. This is critical in the NWT, where communication interruptions in remote communities are common.
• Select an Attorney for your Enduring Power of Attorney (financial decisions). This can be the same person as your Agent, or someone different.
• Have the conversation. Discuss your treatment preferences with every named decision-maker. Do not appoint someone without first confirming they understand your wishes and are genuinely willing to carry them out.

Phase 3: Draft Your Documents

NWT residents need a minimum of two legal instruments:

Personal Directive (under the Personal Directives Act, S.N.W.T. 2005, c. 16):

• Name your Agent and alternate Agent
• Write specific treatment instructions for major clinical scenarios
• Include your residential and personal care preferences
• Add cross-border medevac provisions if you live in a community where Edmonton transfers are realistic

Enduring Power of Attorney (under the Powers of Attorney Act, S.N.W.T. 2001, c. 15):

• Name your Attorney
• Specify the scope of financial authority (broad or limited)
• Decide whether it takes effect immediately or springs into action upon a triggering event
• Explicitly state that the power endures during incapacity

Additional documents to consider:

• Last Will and Testament — governs the distribution of your estate after death
• Goals of Care Designation (GCD) — a clinical form completed with your physician that translates your directive into specific medical orders

Phase 4: Execute Your Documents

This is where many NWT plans fail due to procedural errors:

• Confirm everyone involved is at least 19 years old (Director, Agent, witness)
• Confirm your witness is not your spouse, any named Agent, or any Agent's spouse
• Schedule a single signing session where the Director, Agent(s), and witness are all physically present
• The Director signs and dates the document
• Each Agent signs the acceptance declaration
• The witness signs the attestation clause
• In remote communities, locate a Commissioner for Oaths (RCMP officer, health centre staff, municipal official) if no other qualified witness is available

Phase 5: Distribute Your Documents

A directive locked in a filing cabinet is useless during an emergency:

• Give copies to your primary Agent and alternate Agent
• Give a copy to your primary care physician and ask them to scan it into your electronic medical record
• If applicable, give a copy to your long-term care facility or community health nurse
• Keep the original in an accessible location at home — not a locked safe. The Green Sleeve system (plastic pocket on the refrigerator) is common in NWT healthcare settings
• Create a wallet card with your Agent's contact information and a note that a Personal Directive exists
• Share your Enduring Power of Attorney with your bank and any financial institutions

Phase 6: Prepare for Cross-Border Scenarios

If you live in a community where medevac to Edmonton is a realistic possibility:

• Include cross-border explanatory text in your directive so Alberta Health Services teams can interpret it quickly
• Ensure your Agent is reachable by phone at all times — or name an alternate who is
• Consider providing your Agent with a digital copy (PDF or photo on their phone) they can share with Edmonton physicians immediately

Phase 7: Review and Maintain

• Review your directive at least every three years — the NWT recommendation
• Update immediately if your Agent moves, becomes incapacitated, or is no longer appropriate
• Update after major life events: marriage, divorce, separation, serious diagnosis, relocation
• If you create a new directive, explicitly revoke all prior versions in writing with a new witness
• Confirm your Agent's willingness to serve at each review — people's circumstances and comfort levels change

The Complete Planning Toolkit

The Northwest Territories Advance Directive & Living Will Kit covers every step of this checklist with territory-specific templates, execution guides, distribution trackers, and cross-border preparation worksheets — designed for residents in Yellowknife, regional centres, and remote communities alike.

See more Northwest Territories guides →