Advance Care Planning in Saskatchewan: My Voice Workbook and SHA Resources

What Advance Care Planning Looks Like in Saskatchewan

Advance care planning in Saskatchewan isn't a single document — it's a process the Saskatchewan Health Authority actively promotes to help families think through medical treatment preferences before a crisis forces those decisions under pressure.

The SHA's approach centres on three connected elements: understanding the parent's values and treatment preferences, communicating those preferences to family and healthcare providers, and formalizing them in a legally binding Health Care Directive.

The Health Care Directive is the legal instrument. It's governed by The Health Care Directives and Substitute Health Care Decision Makers Act, 2015, and it does two things: records specific treatment instructions (which interventions the parent does and doesn't want) and appoints a proxy to make medical decisions if the parent can no longer communicate.

What makes Saskatchewan's framework unusually accessible is the execution requirement — or rather, the lack of one. If the parent signs the directive personally, no witnesses, notary, or lawyer certificates are required. The document is legally binding from the moment it's signed and dated. Witnesses are only needed if someone else signs on the parent's behalf because the parent is physically unable to write.

The My Voice Workbook

The SHA provides the My Voice workbook as a structured tool for working through advance care planning conversations. It isn't a legal form — it's a reflection guide that helps the parent and family explore questions like:

• What does quality of life mean to the parent?
• Under what circumstances would they want life-sustaining treatment continued or stopped?
• How do they feel about CPR, mechanical ventilation, artificial nutrition, and dialysis?
• What matters most to them — comfort, function, or extending life as long as possible?

The workbook walks the parent through scenarios they're likely to face and asks them to indicate their preferences in concrete terms. The completed workbook then serves as a reference for the appointed proxy and healthcare team when making treatment decisions.

The SHA also provides the Advance Care Planning Yellow Sleeve — a brightly coloured document holder that goes on the parent's refrigerator or in a visible location. Emergency responders are trained to look for it. Inside, the parent stores their completed Health Care Directive and proxy appointment form, so paramedics and hospital staff can immediately identify who has authority to make medical decisions and what the parent's treatment preferences are.

The Proxy Appointment

Appointing a health care proxy is the piece families most often skip — they complete the treatment preference sections of the directive but forget (or avoid) naming the person who'll actually make the call when the parent can't speak for themselves.

Under Saskatchewan law, the proxy's authority activates only when the parent loses the ability to communicate their own healthcare decisions. The proxy must follow the parent's recorded wishes as closely as possible. When the directive doesn't cover a specific situation, the proxy makes the decision they believe the parent would have made, based on the parent's known values and preferences.

If no proxy is appointed and no personal guardian exists, Saskatchewan's statutory nearest relative hierarchy determines who makes medical decisions. The hierarchy runs in strict order: spouse, then adult children (eldest preferred), then parent, then siblings, and down through grandparents, grandchildren, aunts, uncles, nephews, and nieces. The eldest-preference and whole-blood-preference rules within each tier mean the decision-maker might not be the family member the parent would have chosen.

Naming a proxy avoids all of that. It takes one line in the Health Care Directive.

Where Advance Care Planning Meets Legal Authority

The advance care planning process is the medical half of the equation. The enduring power of attorney is the financial half. They don't overlap — a health care proxy cannot access the parent's bank accounts, and a property attorney cannot consent to surgery.

Families who complete one but not the other end up with gaps that surface at the worst possible moment. A parent gets admitted to a special-care home and the proxy can handle the medical consent, but nobody has legal authority to complete the SHA Financial Package or access the bank account to pay the monthly resident charge. Or the property attorney can manage the finances, but the hospital is asking for consent to a procedure and the property attorney has no standing to give it.

The Saskatchewan Power of Attorney & Personal Directive Kit covers both tracks — the EPA execution process for financial and personal care authority, and the Health Care Directive for medical decision-making — so families can set up both in the same sitting rather than discovering the gap during a hospital stay.

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