A substitute decision-maker is a person who makes care and treatment decisions on another person’s behalf if or when that person becomes mentally incapable of making decisions for themselves. The substitute decision-maker makes decisions based on their understanding of the person’s wishes, or, if these are unknown or not applicable, makes choices that are consistent with the person’s known values and beliefs and in their best interests.
Family consists of those closest to a person in terms of knowledge, care, and affection, and may include biological family, family through marriage, or family of choice and friends. The person with the progressive, life-limiting illness defines their family and who will be involved in their care.
A caregiver is an unpaid person who provides care and support in a nonprofessional capacity, such as a family member, a friend, or anyone else identified by the person with a progressive, life-limiting illness. Other terms commonly used to describe this role include care partner, informal caregiver, family caregiver, carer, or primary caregiver.
Goals of care
A person’s goals of care are their overall priorities and health expectations for care; these are based on their personal values, wishes, beliefs, and perception of quality of life, and what they characterize as meaningful and important. Examples of goals of care could be curing the disease, prolonging life, relieving suffering, optimizing quality of life, maintaining control, achieving a good death, and getting support for family and loved ones. Goals of care are not the same as health care decisions or consents for treatments.
Interdisciplinary health care team
An interdisciplinary health care team consists of two or more people with different types of training and skills who work together to provide care based on a person’s care plan (see Quality Statement 5). The composition of the team varies depending on the services needed. The team may include various roles, as needed: physicians, nurse practitioners, registered nurses, registered practical nurses, social workers, psychologists, spiritual care providers, pharmacists, personal support workers, dietitians, and volunteers.
Consent to treatment
Consent to treatment (health care consent) refers to an informed decision involving a mentally capable person or their substitute decision-maker and a health care provider as outlined in the Ontario Health Care Consent Act. Health care providers proposing treatment must obtain informed consent from either a capable person or their substitute decision-maker if they do not have the mental capacity. This discussion must address present condition (context), available treatment options, risks, benefits, side effects, alternatives to treatment and what would happen without the proposed treatment.