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Advanced Care Planning Tips for BC

Hours Updated onMay 3, 2025 Categories BC
estate planning guidance tips

In BC, effective advance care planning requires three key documents: an Advance Directive outlining healthcare wishes, a Representation Agreement appointing a healthcare decision-maker, and a MOST Form completed by your physician. Verify documents are properly witnessed by two adults who are not your representatives or their spouses. Choose representatives wisely based on trust, communication skills, and availability. Review documents every 3-5 years or after significant life changes. The following information will guide you through creating a thorough plan aligned with your estate strategy.

Understanding the Difference Between Advance Directives and POAs

While many people confuse advance directives with powers of attorney, these legal documents serve distinctly different purposes in your estate planning toolkit.

An advance directive specifically addresses your healthcare wishes when you are unable to communicate, outlining treatment preferences and end-of-life care decisions. It is a direct instruction to healthcare providers that does not require an intermediary.

In contrast, a Power of Attorney (POA) in BC focuses exclusively on financial and legal matters. It does not grant authority to make medical decisions on your behalf.

For healthcare decision-making authority, you will need a Representation Agreement, which appoints someone to interpret your wishes and make health and personal care choices when you cannot.

Understanding this distinction guarantees you have properly addressed both financial and healthcare aspects of your estate planning.

Key Components of a Comprehensive BC Advance Care Plan

Because every thorough advance care plan in BC requires specific legal elements to be effective, understanding each component is essential for proper preparation. Your plan should include both an advance directive that documents your healthcare wishes and a representation agreement appointing someone to make decisions on your behalf if you’re incapable.

DocumentPurposeRequirements
Advance DirectiveOutlines healthcare instructionsMust be signed, witnessed by two adults
Representation AgreementAppoints healthcare decision-makerMust specify Section 7 or 9 powers
MOST FormCommunicates medical ordersMust be completed with physician


Do not forget to include your values and beliefs that should guide treatment decisions. Review and update your documents regularly, especially after major life changes or health status updates.

Selecting the Right Representation Agreement for Your Needs

When should you choose between the two types of Representation Agreements available in BC? The decision depends on your specific needs and circumstances.

Choose a Section 7 Agreement if you want your representative to assist with health and personal care decisions but not make end-of-life choices. This option is appropriate if you have some decision-making challenges but can understand the agreement’s purpose.

A Section 7 Agreement allows for healthcare assistance while preserving your autonomy over end-of-life decisions, ideal for those with limited capacity.

Opt for a Section 9 Agreement when you want your representative to have broader authority, including refusing life support or life-prolonging medical treatments. This extensive option requires you to be fully capable when signing.

Remember that your representative must follow your previously expressed wishes.

Review your agreement regularly to guarantee it continues to reflect your values and preferences as your life circumstances change.

How to Choose an Effective Healthcare Representative

Beyond selecting the appropriate type of Representation Agreement, identifying the right person to serve as your healthcare representative is a significant decision that requires careful consideration. Your representative will be responsible for making critical healthcare decisions when you cannot speak for yourself, so you will want someone who understands your values and can advocate effectively on your behalf.

Selection CriteriaWhy It Matters
TrustThey will make decisions when you are vulnerable
Communication SkillsMust effectively advocate with healthcare providers
AvailabilityShould be accessible when decisions are needed
Emotional StabilityCan make difficult choices under pressure


When choosing your representative, consider someone who lives nearby, understands medical terminology, and has demonstrated reliability during stressful situations. Do not hesitate to have detailed conversations about your wishes with potential candidates.

Legal Requirements for Valid Advance Care Documents in BC

For your advance care documents to be legally binding in BC, they must meet specific formal requirements that guarantee their validity and enforceability.

Both advance directives and representation agreements must be in writing, dated, and signed by you in the presence of two witnesses who are at least 19 years old. Only one witness is required if that person is a lawyer or notary public.

Your witnesses cannot be your representative, their spouse, or anyone you have appointed as a substitute decision-maker. They must understand what they are witnessing and be mentally capable.

Remember that electronic signatures are not valid for these documents, and your representative must also sign the representation agreement to confirm their acceptance of the role.

When and How to Update Your Advance Care Plan

Life events and changing health conditions necessitate regular reviews of your advance care plan to confirm it still reflects your current wishes and circumstances.

Experts recommend updating your plan every 3-5 years, or whenever you experience significant life changes such as marriage, divorce, death of a loved one, or a new diagnosis.

To update your plan, simply create new documents and destroy outdated versions. Verify you have communicated changes to your healthcare representative, family members, and healthcare providers.

You will need to re-sign and have witnesses validate any revised advance directives or representation agreements according to BC law.

Remember to distribute copies to your doctor’s office and hospital records department and store the original in an accessible location your family knows about.

Storing and Distributing Your Advance Care Documents

After updating your advance care documents, proper storage and distribution are essential to guarantee your wishes are followed when needed. Store your documents in multiple secure locations while making them accessible to your representatives and healthcare providers when required.

Document TypeWhere to StoreWho Should Receive Copies
Advance DirectiveHome safe or fireproof boxPrimary physician, hospital
Representation AgreementWith your lawyerYour representative, alternate
MOST FormIn your “Greensleeve” folderHealthcare team, family members


Consider using a “Greensleeve” folder—a green plastic folder specifically designed to hold advance care planning documents that healthcare providers recognize immediately. Keep digital copies in password-protected cloud storage and tell your representative how to access them. Review your distribution plan annually to guarantee everyone has the most current versions.

Navigating the TSDM System if No Prior Planning Exists

When a medical emergency occurs without advance care planning in place, British Columbia’s Temporary Substitute Decision-Maker (TSDM) system activates automatically.

Healthcare providers will follow a legally mandated hierarchy to identify who can make decisions on your behalf. The order begins with your spouse, then adult children, parents, siblings, and extends to other relatives and close friends.

Your TSDM must be at least 19 years old, capable of making decisions, in contact with you within the past year, and have no disputes with you.

They are legally required to follow any known wishes you have previously expressed. Without documented preferences, they must decide based on your best interests—a burden that could be avoided with proper advance care planning.

Aligning Your Estate Plan With Your Healthcare Wishes

A thorough estate plan goes beyond simply distributing your assets—it should also reflect your healthcare preferences. When creating your estate plan, confirm it aligns with your advance care planning documents. Your Representation Agreement and Advance Directive should complement your Will and Enduring Power of Representative, creating a detailed framework that addresses both financial and healthcare matters.

  • Review all documents together to identify potential conflicts between financial instructions and healthcare wishes.
  • Consider appointing the same person as both your Representative and Power of Representative if they are skilled in both areas.
  • Schedule regular reviews of all documents, especially after major life events like marriage, divorce, or serious illness.

Remember that healthcare planning and estate planning are not separate processes—they are interconnected aspects of making sure your wishes are respected throughout your lifetime.

How Vest Estate Law Can Help

Maneuvering the complex intersection of estate planning and advance care planning requires expert guidance to guarantee your wishes are properly documented and legally enforceable.

As a boutique firm focused exclusively on wills and estates law across BC and Alberta, Vest Estate Law provides the specialized expertise you need.

Our dedicated team of legal professionals can help clarify the distinctions between advance directives, representation agreements, and powers of representation, ensuring these documents complement your estate plan.

We will guide you through creating legally sound documentation that precisely reflects your healthcare wishes while seamlessly integrating with your broader estate strategy.

Should disputes arise, our experience in estate litigation means we are equipped to protect your interests.

Work with a firm like Vest that understands the nuances of estate law and can provide the extensive support you deserve.

Frequently Asked Questions

Can My Healthcare Representative Override My Advance Directive?

In BC, your representative’s decisions typically override your advance directive unless you have specified otherwise in your Representation Agreement. This allows flexibility when healthcare situations require judgment beyond written instructions.

How Does MAID (Medical Assistance in Dying) Fit Into Advance Planning?

MAiD cannot be requested in advance directives. You cannot pre-authorize it in your advance care plan, as you must be capable of providing informed consent when requesting MAiD services.

Are Digital/Electronic Advance Care Plans Legally Valid in BC?

Yes, your digital advance care plans are legally valid in BC as long as they are properly executed with valid signatures and witnesses according to BC’s legislation requirements.

Can I Create Different Directives for Different Medical Scenarios?

Yes, you can create different directives for specific medical scenarios in your advance directive. This allows you to customize your healthcare instructions based on various potential health situations you might face.

How Do Advance Care Plans Work During Travel Outside BC?

Your BC advance care plans may not be recognized in other provinces or countries. You will need to check local laws and consider creating jurisdiction-specific documents when travelling extensively outside BC.

Vest BC Map

Our main hub for British Columbia is located in the heart of Vancouver. That said, we serve the entire province of BC. We have the infrastructure to work with any of our clients virtually — even in the furthest regions of British Columbia.

Call (604) 256-7152 [toll free 1 (877) 415-1484] to get routed to the best representative to serve you or contact us online to schedule an appointment.

We also have a dedicated intake form to help you get the ball rolling. Our intake team will review your specific case and advise you on the next steps to take and what to expect moving forward.

Our offices are generally open 8:30 a.m.—4:30 p.m., Mon—Fri.

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Kelly Sullivan - Vest Estate Law

Kelly Sullivan

WILLS and ESTATES PARALEGAL

Kelly is a highly accomplished Paralegal with an impressive 28-year tenure in the legal industry, specializing in estate administration and estate planning at Vest Estate Law.

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