For Patients and their Families
How can I plan ahead for my hospital stay?
Before coming to the hospital, you can:
- Complete an advanced directive, and engage in Advanced Care Planning
- Discuss your goals and wishes regarding medical treatment with your family and health care providers.
Completing an advanced directive and discussing your wishes:
Lets everyone involved in your care know what is important to you.
Ensures that your wishes are followed in case you become unable,
even temporarily, to make your own medical decisions.
Planning ahead helps you feel confident, knowing that you are in control
What are advance directives?
Advance directives are legal documents that describe who should oversee your medical treatment and what your wishes are, in case you are unable to speak for yourself.
Advance directives include:
- A Power of Attorney for Personal Care, and
- A Living Will.
What is Advance Care Planning?
Advance Care Planning is a process of communicating your wishes for end of life care with your family and health care provider. It also includes naming a Substitute Decision Maker to speak for you if you are unable to do so. In the best of circumstances, the patient, the family, and the physician have held discussions about treatment options, including the length and invasiveness of treatment, chance of success, overall prognosis, and the patient's quality of life during and after the treatment or care. Ideally, these discussions would continue as the patient's condition changes.
For more information: Read “A Guide to Advance Care Planning” available from the Ontario Seniors Secretariat website.
What other documents can help me share my wishes for medical treatment?
To have a clearly documented end-of-life care treatment plan and resuscitation status that is aligned with your wishes, values and goals for treatment you can ask your doctor to fill out a Physician Ordered Scope of Treatment form (or “POST order”) when you are admitted to the hospital.
The POST order tells all members of the healthcare team about your treatment goals and wishes and supports the needs or you and your family.
How will decisions about my care be made while I am in hospital?
A team of people will plan your care at the hospital. You and your family are important members of this team. The team also includes many types of health care providers. Each one contributes to providing care that is right for you.
Depending on your needs, your health care team may include:
Health Professionals in training
The health care providers will work with you and your family to identify your needs and plan care to meet those needs. To help you make decisions and take part in your care, your health care providers will give you information and support.
How will my family and health care team know if I am capable of making decisions about my care?
The ability to make your own health care decisions can change over time, depending on your condition and the type of decision you are facing. For example, if you become severely ill or unconscious, you would be unable to speak for yourself or guide your care.
Your health care provider is responsible for assessing whether or not you are capable of making specific decisions regarding your care. The doctor and social worker may need to be involved in this process.
To be considered capable of directing your own medical treatment,
If a member of your family believes you are not capable of making decisions, he or she should talk with your health care provider.
If the heath care provider’s assessment indicates that you are not able to make decisions and direct your own care, you will need a Substitute Decision Maker.To make decisions for you, this person needs to have a clear understanding of your wishes and values, and be able to represent your best interests.
Who can be a Substitute Decision Maker?
The law provides a list of people who can be the Substitute Decision Maker.
In order of priority, these are:
These are legally appointed positions and may not applyto the general public.
The person named in a Power of Attorney for Personal Care (not the Power of Attorney for Property)
A representative appointed by the Consent and Capacity Board
A spouse or partner
A child or parent
A parent with right of access only
A brother or sister
Any other relative by blood or marriage
A Public Guardian and Trustee
To be a Substitute Decision Maker, the person must be:
16 years of age or older (unless he or she is the parent of a child requiring care).
Capable of making the decision that is needed.
Willing and available to take on this role.
For more information:
- Read ‘Making decisions for others: Your role as a Substitute Decision Maker’ an information sheet for patients and families at Hamilton Health Sciences.
- Review the laws in Ontario about making decisions for someone else. The Health Care Consent Act of Ontario and the Substitute Decisions Act of Ontario are available from the Consent and Capacity Board website: http://www.ccboard.on.ca/.
If I have questions or concerns about my care, how do I work with my healthcare team to get things resolved?
If you are concerned about any aspect of your care or need more information, please do not hesitate speak to a member of your health care team. You are also welcome to speak with other team members or the manager of the unit, if needed.
We would like to resolve any issues you have as soon as possible
If you would like help to resolve an issue, please contact the Patient Relations Department.
The Patient Relations Department:
- Provides confidential advice and support. They will address any concerns you may have as a patient, relative, caregiver, or user of one of our services.
Acts independently when handling your concerns. Patient Relations staff communicate with hospital staff, managers and other experts as needed, to help solve problems and concerns.
To contact Patient Relations:
For more information
Hamilton Health Sciences has two booklets that can guide you in working with the healthcare team:
- Mutual Respect (for patients and Families at Hamilton Health Sciences).
- Mutual Respect (for parents at McMaster Children’s Hospital)
How can I get a copy of my health record? Can I make changes if I feel some of the information is incorrect?
You can see your health record or get copies by submitting a written request to the Release of Information Clerk in the Department of Health Records at the hospital where you were treated. For more information, go to the Patient Privacy section of the Hamilton Health Sciences website and click on “How do I obtain a copy of my health record?”
If you wish to make your request in person, please call the Health Records Department before coming to the hospital, to make sure a staff member is available to help you.
- Juravinski Cancer Centre – ext. 63315
- St. Peter’s Hospital – ext. 12216
- McMaster University Medical Centre – ext. 75123
- Hamilton General Hospital – ext. 46769
You have the right to request a correction if you feel that information in your health record is incorrect. For more information, go to the Patient Privacy webpage and click on “Privacy F.A.Q” Question #15.
What is an ethical issue? How do I know if I am experiencing one?
To learn the signs of an ethical issue or dilemma, read “Recognizing an Ethical Issue” in the Ethics Resources section of Hamilton Health Sciences’ website.
How can I get help if I am experiencing an ethical issue with my health care team or my family?
If you are experiencing an ethical issue, call the Ethics Consultation Service.
This specialized group of professionals is available to support you.
Any member of the HHS community (including patients, relatives,
Permission from a doctor or manager is not required.
How to contact the Ethics Consultation Service
Monday to Friday from 9 am to 5 pm:
After hours and on weekends:
When should I request an Ethics Consultation?
If you, your family, or your health care team are struggling to balance different values and principles when facing difficult choices, an Ethics Consultation can help.
There are many situations in which Ethics Consultation may be helpful. For example:
- When there are disagreements regarding a patient's treatment plan, quality of life or goals of care.
- If you find yourself wondering what is the right thing to do in a complex medical situation.
For more examples go to “When should I request an ethics consultation?”
The Ethics Consultation Service is available Monday to Friday from 9:00 am to 5:00 pm:
- Call 905-521-2100 and ask to page the Ethics Consultation Service or dial extension 76443 if you are calling from within the hospital.
- Please leave your name and phone number at which you may be reached.
- An Ethics Consultant will call you back within an hour to discuss the situation.
- If calling after hours, please phone ext. 73661 and leave a message. An Ethics Consultant will contact you the next business day.
Click here for the Clinical Ethics brochure.