Goals of Care Designation Order

• What is a goals of care designation order?
• Who needs a goals of care designation order?
• How is a goals of care designation order created?
• What goes into a goals of care designation order?
• Why is it important?
• What do I do to prepare a goals of care designation order?
• Goals of care designation FAQs
• Resources

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 in the event that 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.

Who needs a goals of care designation order?

Not everyone will need a goals of care designation order. 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 goals of care designation order created?

Your doctor or nurse practitioner will fill out this document for you after having a conversation with you about your wishes, values and medical problems. Your personal directive can also help inform this process.

You do not write or sign the goals of care designation order for yourself or someone else 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.

Since your values, wishes and your health can change, you can change your goals of care designation order as many times as you want by talking to your health care provider.

What goes into a goals of care designation order?

A goals of care designation order specifies the level of care that best aligns with your wishes, values and medical situation. There are three general approaches to care:

• Medical care: provides all suitable care to manage or cure illnesses without using unwanted intensive treatments.
• Comfort care: provides as much support, care, and comfort as possible, to ease symptoms from incurable illness.
• Resuscitative care: provides all suitable intensive treatments to prolong and preserve life as long as possible.   

Using a letter and number system, the doctor will indicate in the goals of care designation order which of these approaches of care is best for you, based on your wishes, values and medical situation.

Where and how the goals of care designation conversation occurred will also be recorded.

Why is it important?

It ensures that your health care team only does what you want and not the things that do you not want.

If you don’t have a goals of care designation order, the health care team will try all the treatments to keep you alive as long as possible. You may not like some of these treatments (such as shocking your heart to restart it) which may create other complications that will impact your quality of life.

Therefore, it is important to inform your doctor or nurse practitioner of your wishes so they can put them in your goals of care designation order.

What do I do to prepare a goals of care designation order?

Only your doctor of nurse practitioner can fill in this document. However, you do not have to wait until they bring up the subject. You can start the conversation yourself.

It is best to have your personal directive completed first, so that you can think about your values, wishes and goals. After that, you should talk to your health care provider to tell them how you want to be cared for and they will fill out your goals of care designation order.