Goals of Care Designations (GCD) 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 or with you and your agent, a doctor or nurse practitioner will write your GCD as a medical order. Figuring out your GCD is not just about finding out what your wishes are, but also about getting to know you better as a person.
In a medical emergency, your GCD order guides your healthcare team to provide timely care that best reflects your health condition, the treatments that will benefit you, and your own wishes and values.
The GCD order:
- is a medical order that describes the general focus of your care
- helps the healthcare team match your values and preferences to care that is most right for you and your health condition
- is written by a doctor or nurse practitioner
- is ideally created after you’ve had conversations with your healthcare team
- is recognized in all care settings in Alberta, such as hospitals and long-term care facilities
- changes as your health changes
- can be updated by any doctor
Who needs a GCD order?
It’s important to have a GCD order when full resuscitative care is not what you want or is not medically appropriate. Without a GCD order stating otherwise, your healthcare team will give you full resuscitative care when your heart stops beating or you stop breathing.
To find out if you need a GCD order, talk to your healthcare provider.
What will my healthcare provider discuss with me if I need a GCD order?
If you need a GCD order, you’ll have a conversation with your healthcare provider. Here are some questions that will likely come up in your conversation. You can think about them to prepare to talk to your healthcare provider:
- Do I fully understand my health conditions and what I can expect for my health in the future (my prognosis)?
- What are my treatment risks and benefits?
- Are life-saving measures like CPR (cardio-pulmonary resuscitation) likely to benefit me?
- What would I be willing to go through for more time? Is quality of life more important than living longer?
- What treatments are available where I live so I don’t have to go to the hospital?
- What treatments will help me live the way I want and where I want?
- With this illness, what can I expect my life to look like in 1 month, 6 months, or 1 year?
- If I get sicker, are there medical treatments that I feel strongly about having or not having?
Can my GCD order change?
Your GCD order can and should change as your health changes. Your healthcare team may talk to you about your GCD at these times:
- You’re admitted to a hospital or care facility.
- You’re going to have surgery.
- You’re transferred from 1 healthcare facility to another.
- You come to an emergency department or urgent care centre.
- You have a yearly checkup with your family doctor.
Talk with your healthcare team when things change or you have questions. For example:
- Your health, values, or wishes have changed.
- You aren’t sure what your GCD order includes.
- You aren’t comfortable with the GCD order you have now.