Abstract

In this paper we explore proposals for encouraging discussion of advance-care planning. The importance of advance-care planning is underscored by the aging of our population, particularly the large post-war baby-boom generation who are entering their senior years. The paper is based on the results of our earlier survey of residents of a western Canadian province about how the general public values and plans for serious illness. Our findings indicated that most respondents felt it was important to plan for medical care in the event of serious illness, yet only a small percentage had actually completed a written living will or advance-care plan. In this paper, we use the transtheoretical model of intentional behaviour change to argue that policy proposals must take into account the association between readiness to engage in planning for serious illness and personal experiences or turning points such as planning a funeral. Based on the model, a demographic analysis and our previous empirical findings, our proposals for encouraging discussion of advance-care planning center around physician-initiated conversations and peer-to-peer education (such as death cafes and death dinners) often associated with social marketing campaigns