Common Misunderstandings About Advance Care Planning
Why future healthcare planning matters more than people realize.
The majority of people, when they hear the term Advance Care Planning (ACP), assume it’s only for seniors, people who are seriously ill, or those nearing the end of life. In reality, advance care planning is something that every adult can benefit from–well before a crisis happens.
According to Advance Care Planning Canada, ACP is simply “the process of thinking about what matters most to you in your life and what that means for your health and personal care.” In other words, it’s not just about medical paperwork–it’s about reflecting on what’s important to you, communicating your preferences and values, and helping prepare others to make decisions on your behalf if you were unable to speak for yourself.
ACP is a key aspect of general life planning, just like estate or financial planning. Yet encouraging people to engage with it in a substantive way often feels challenging. I believe that most people avoid it, not because they don’t care, but because they misunderstand what it actually is, or the reasons we do it.
Some people assume that their family knows what they want. Others believe that having a will is enough, or that the healthcare system will somehow handle things if something were to happen.
These assunptions are incredibly common–and completely understandable. Most of us have never been taught how healthcare decisions are made during emergencies, serious illness, or incapacity.
Here are some common misconceptions I’ve encountered around advance care planning–and why they matter.
“I’m healthy – I don’t need advance care planning yet.”
It’s somewhat ironic, but the ideal time to think about advance care planning is usually when you are healthy.
When people are in crisis, have just faced a life-changing diagnosis, or are overwhelmed, it’s much harder to make clear-headed decisions, or have meaningful conversations. Thinking ahead, when our nervous systems are not in overdrive and we’re not time constrained, sets a better stage for reflection and calm, intentional planning.
Advance care planning is not just for people who are dying. Accidents and unforeseen medical events can happen anywhere and at any age. Although it’s impossible to prepare for every possible scenario, having important conversations can help those closest to us understand our wishes, values, and priorities if the unexpected occurs.
“Advance care planning is for seniors.”
Aging is a reason people naturally think about future health and personal care decisions, but ACP is relevant to adults of all ages.
Many people in their 30’s, 40’s, and 50’s are already in a caregiving role for aging parents, partners, or family members. Others have adult kids or spouses who would be the ones left to make difficult decisions on their behalf if they became incapable.
Advance care planning is not so much about age as it is about preparedness, communication, and reducing uncertainty during trying times. It can be thought of it as a gift we give to the ones we love.
It helps families avoid confusion, conflict, and the painful process of having to guess what someone would have wanted in the midst of a medical crisis.
“My family already knows what I want.”
Many families assume they are on the same page–until they are suddenly thrust into a situation where hard decisions need to be made under stress.
One of the challenges with a serious illness and medical emergency is that there are different interpretations of quality of life, suffering, and “doing everything possible” . Even family members who consider themselves to be closely aligned can have varying assumptions, recollections, and beliefs about what someone would want.
For potential substitute decisions makers, advance care planning conversations help move them beyond vague understanding and towards clarity and confidence.
These discussions don’t need to focus on medical treatments or interventions. They often begin with broader questions that aren’t so emotionally charged:
What makes life meaningful for me?
What are some of my favourite activities that make life joyful and worthwhile?
Who do I trust to make decisions on my behalf?
What are some fears I have if my health status changed?
“I’ve already done my will.”
A will is a critical part of life planning, but it serves a very different purpose.
Wills come into effect after someone dies and focuses primarily on the estate, financial matters, and the distribution of assets. Advance care planning, on the other hand, is about health and personal care decisions (including where someone will live) while a person is still living.
In British Columbia, advance care planning may involve conversations about representation agreements, advance directives, substitute decision makers and other relevant healthcare documents. But at it’s core, it’s less about the forms, and more about helping others understand what your wishes and preferences are if you cannot speak for yourself.
A will answers the question, “What happens after I die?”
Advance care planning answers, “In the event that I’m incapable of making decisions, how can I help make sure that the care I receive actually aligns with what I want?”
“It’s only paperwork.”
Paperwork matters, but it’s not everything.
One of the biggest misconceptions about advance care planning is that it simply involves filling out forms and putting them in a drawer to be pulled out some time in the distant future. In reality, the most important part of ACP is the conversations we have that accompany the documents.
Most healthcare situations are not black and white–they are deeply nuanced. Medical decisions happen in the grey areas and are filled with trade-offs and emotional complexity. Documents alone cannot capture a person’s values, fears, relationships, or definition of quality of life.
This is exactly why conversations over time with family members, caregivers, healthcare providers, and chosen substitute decision makers are so important. They provide critical guidance in those grey areas that paperwork cannot address.
“The healthcare system will handle it.”
Many people assume–or hope–that if something happens to them, healthcare providers will somehow know what to do.
Without guidance, healthcare teams will often default to the highest degree of intervention and life-saving measures. This is not wrong; they are trained to preserve life whenever possible, unless they are told otherwise. But aggressive treatment is not always aligned with a person’s wishes, values, and definition of quality of life.
Someone may strongly feel that they would want every possible intervention to prolong life at any cost. Someone else might feel completely different if treatment would prolong life without also restoring their ability to communicate, or be independent.
These are deeply personal decisions that can’t be answered by the default protocols of the healthcare system.
It’s important to remember that advance care planning is not about controlling every possible outcome–that would be impossible. Rather, it’s about creating clarity, preserving your agency and wishes, and providing valuable guidance to loved ones and healthcare teams if difficult decisions need to be made.
Final Thoughts
Advance care planning is not only about death, and it’s not just for seniors. At it’s heart it’s about communication, feeling prepared, and preserving what matters most to us in times of uncertainty.
Having these conversations can feel uncomfortable at first, but when we begin to share with our people what is important to us and what gives us meaning, it can be deeply connecting, grounding, and life-affirming. It can reduce unnecessary stress for families and loved ones, and help ensure that people are cared for in ways that reflect their wishes and values.
If you are curious about learning more, want to know what is included in an advance care plan, or would like more in-depth personal guidance on how to begin the process of advance care planning in BC for yourself or a loved one, you are welcome to reach out to me at any time. I would love to hear from you.
Sarah xx
