Goals of Care Designations
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If you became too sick to speak for yourself, would your family or close friends know what kind of care you would want? Have you talked to them about what's important to you about your healthcare?
Goals of Care Designations are instructions that guide your healthcare team about the general focus of your care, and where you might want that care. After speaking with you and/or you and your agent, a doctor or nurse practitioner will write your Goals of Care Designation as a medical order. Figuring out your goal of care is not just about finding out what your wishes are, but also about getting to know you better as a person.
“When a patient talks to me about what’s important to them, and what their hopes are, we can work together to define the goals for their care. These conversations help me understand the patient’s wishes in light of their health circumstances so that we can create the most appropriate Goals of Care Designation.”
By knowing and following your Goals of Care Designation, healthcare providers care for you in a way that is timely, medically appropriate, and meets your values and wishes. It’s also an organized way for care teams to communicate about some parts of your care as you move between locations of care.
Goals of Care Designations are created just for you and your situation. They can change if your situation changes or you want to change something you had decided earlier.
There are three general approaches to care, or Goals of Care:
Medical Care (M) – Medical tests and interventions are used to cure or manage an illness as well as possible but don’t use resuscitative or life support measures. This is appropriate when resuscitative and life support measures won’t work or when the person chooses not to have these treatments. Medical care can be given in many Locations, depending on the person’s wishes and values as well as if it’s appropriate medically.
Resuscitative Care (R) – The focus is to extend or preserve life using any medical or surgical means. This includes, if needed, resuscitation and admission to the intensive care unit. Talk to your healthcare team about which Goal of Care designation best reflects your health circumstances and your wishes and values.
Comfort Care (C) – The focus of care is to provide comfort to ease a person’s symptoms without trying to control the underlying illness. This is for people who have a life-limiting illness, when treatments can’t influence the course of that illness. This care can be given in any setting.
Within these three main approaches to care (Resuscitation, Medical, and Comfort Care), there are sub-categories. These are used to further define and communicate your Goals of Care designation to healthcare providers.
Decisions about Goals of Care designations are reached over time. They come about after conversations you have with your family (if you wish) and your healthcare team about your health condition and prognosis, the current and future treatment options, and your wishes for your healthcare in the future.
Your doctor and other members of your healthcare team will work with you to help choose a Goals of Care designation that best reflects your values and beliefs, your health condition, and the appropriate treatment options.
The Goals of Care Designation medical order and care decisions are documented on Alberta Health Services’ forms. They are kept in a
Green Sleeve that all healthcare teams in all areas of Alberta Health Services recognize. When you move throughout the system, the
Green Sleeve should go with you so that healthcare providers always know about the decisions you’ve made and your Goals of Care Designation.
When you’re at home, keep your
Sleeveon or near your fridge. This is where healthcare providers such as Emergency Medical Services will look for it. Any time you go to the hospital or to any healthcare provider, take your
Green Sleeve with you (remember to take it with you when you leave).
Yes, while your Goals of Care Designation can be changed at any time, it should be reviewed if:
“Talking with my healthcare team about my health circumstances, beliefs and values helps me feel included when deciding the most suitable goal of care designation for me and my circumstances.”
Current as of: April 2, 2018
Author: Palliative and End of Life Care Team, Alberta Health Services
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