What is a Goals of Care Designation order?
A Goals of Care Designation order (or GCD) is a document that provides medical instructions to your health care team on how you wish to be cared for if you are unable to tell them yourself.
It specifies the level of care that best aligns with your wishes, values and medical situation.
For other resources on goals of care designation orders, visit the GCD section of our resource directory.
Why is it important?
It ensures that your health care team only does what you want.
If you don’t have a GDC, the health care team will try everything to keep you alive as long as possible. You may not like some of these treatments (such as shocking your heart to restart it), and some may create other complications that will impact your quality of life.
It is important to inform your doctor or nurse practitioner of your preferences so they can put them in your GDC.
Who needs one?
Not everyone will need a GCD. Your health care provider is best suited to tell you if you need a GCD, but more resources are provided below if you feel this might apply to you.
How is a GDC created?
Your doctor or nurse practitioner will fill out this document for you after having a conversation with you about your preferences and medical problems. However, you do not have to wait until they bring up the subject. Your personal directive can also help inform this process.
You do not write or sign the Goals of Care Designation order yourself as this is a medical order. However, you decide how you’d like to be taken care of so speak up about what you want.
You can change your Goals of Care Designation order as many times as you want.
What goes into a GCD?
A GCD specifies the level of care that best aligns with your preferences and medical situation.
There are three general approaches to care:
- Resuscitative care: all suitable intensive treatments to prolong and preserve life as long as possible.
- Medical care: suitable care to manage or cure illnesses without using unwanted intensive treatments.
- Comfort care: as much support, care, and comfort as possible to ease symptoms from incurable illness.
Using a letter and number system, the doctor will indicate in the GCD which of these approaches of care is best for you.
Where and how the conversation occurred will also be recorded.
Goals of Care Designation order FAQs
There are multiple times when your GCD should be reviewed:
- If you change your mind or your health status changes
- When transferred to a new location of care
- Yearly check up with your doctor
You may have multiple GCD in your file (e.g., due to health status and or location changes), but only the most recent order is valid.
A GCD is a medical order that a health care provider writes for you about your health care.
Your personal directive is a legal document that you write yourself to describe your values and wishes for your personal matters.
Tell all your health care providers and trusted ones that you have these documents in place.
When more people know about your documents, the more likely it is your care will align with your preferences.
Facing a life-limiting illness?
Hello. I am John. I have been very sick for quite a while and it cannot be fixed. I have made peace with the fact that the end is near for me.
I have a goals of care designation that makes clear my wishes for end-of-life treatment and my doctor and their team know exactly what kinds of care they can provide for me. Having all that in place gives me a great deal of comfort.