Power of Attorney for Personal Care and Medical Decisions
Personal care decisions:
While you are capable, only you can decide about your personal care. If you become incapable, others can make those decisions for you. This includes medical treatment, admission to care facilities, and personal assistance services.
Medical treatment decisions:
This includes therapeutic, preventive, palliative, diagnostic and other health- related treatment. If you are not capable of consenting to medical treatment, your “substitute decision-maker” can do so for you.
Your substitute decision-maker must follow your wishes. If you have not expressed your wishes, your substitute decision-maker decides according to your best interests. Your best interests include your values and beliefs that you would act on, and held while you were capable, and that are known to the substitute decision- maker.
Emergency treatment can be given without your consent, unless the health practitioner believes that you, while capable, expressed a wish regarding the treatment.
Admission to care facilities:
This includes a home for the aged, a rest home, and a nursing home. If you are not capable of giving your consent to admission, your substitute decision-maker can do so. Your substitute decision-maker must follow your wishes expressed while you were capable. In a crisis, you can be admitted without consent.
Personal assistance services:
This includes assistance with, or supervision of, hygiene, washing, dressing, grooming, nutrition, and other routines of living. If you are not capable of giving your consent to personal assistance, your substitute decision-maker can do so. If known, your wishes expressed while you are capable are to be followed.
Who is my substitute decision-maker?
Your substitute decision-maker is, and in this priority, the court-appointed guardian of your person, your “attorney for personal care”, your spouse or partner, your child or parent, your sibling, or any other relative. However, for the purposes of personal assistance services, your child or parent cannot make decisions for you unless you name them in a power of attorney for personal care.
The power of attorney for personal care:
You can give a written “power of attorney for personal care” authorizing your attorney or attorneys for personal care to make the decisions described above for you, if you are not capable when the decision is to be made.You can give a written “power of attorney for personal care” authorizing your attorney or attorneys for personal care to make the decisions described above for you, if you are not capable when the decision is to be made.
Who can I appoint?
You can appoint anyone you choose as your attorney for personal care, except that you cannot appoint someone who is paid to provide health care or residential, social, training or support services to you, unless he or she is your spouse, partner or relative.
When are persons incapable of deciding about personal care?
Persons are incapable of personal care decisions if they don’t understand what is relevant to their health care, nutrition, shelter, clothing, hygiene or safety, or they can’t appreciate the consequences of making, or not making, a decision.
Can I appoint more than one attorney for personal care?
You can name two or more attorneys for personal care. They will act jointly (they must all agree) unless you say otherwise (you can say “jointly and severally” which means they can agree if all are present, or if they are not available one of them can make a decision). If one of them dies, becomes incapable or resigns, unless you say otherwise, the remaining attorney can act. You may include instructions, conditions and restrictions in the power of attorney.
How should my power of attorney for personal care be signed?
To sign it, you need two witnesses. Your attorney and his or her spouse, your spouse or partner, your child, and someone under 18, cannot be a witness.
When can my attorney for personal care begin to make decisions for me?
If you become incapable of making a personal care decision, or if your attorney reasonably believes
that you are incapable of making the decision, your attorney can make the decision.
Can my attorney for personal care resign?
Your attorney may resign. If she or he has acted under the power, to resign, your attorney must notify you (the grantor), any other attorneys named in the power of attorney, the substitute attorney if named, and if there is no substitute attorney who is willing to act (unless the power says otherwise) your spouse or partner and relatives known to your attorney and who live in Ontario. Your attorney must also notify those with whom she or he has been acting on your behalf and with whom further dealings are likely.
When does my power of attorney for personal care end?
It ends if your attorney dies or becomes incapable or resigns, unless there is another joint attorney or there is a substitute attorney. It also ends if you do a new power of attorney for personal care, unless you provide that there shall be multiple powers of attorney for personal care. It also ends if the court appoints a guardian of your person.
What about a decision other than for medical treatment, admission to a care facility, or for personal assistance services?
If there is a decision about your personal care that you cannot make because you are incapable, your attorney for personal care can make the decision in accordance with your wishes or instructions you made while capable, and the attorney should try to find out if you made any wishes or instructions.
What records does my attorney for personal care keep?
Your attorney is required to keep these records:
- list of the decisions regarding your health care, safety and shelter, with the nature of each decision;
- a copy of medical reports or other documents, if any, relating to each decision;
- the names of any persons consulted in respect of each decision and why they were consulted;
- a description of your wishes, if relevant to each decision, that you expressed when capable, and the manner in which they were expressed;
- a description of your current wishes, if ascertainable and if they are relevant to the decision;
- for each decision taken, your attorney’s opinion on each of these factors: Is the decision likely to improve the quality of your life, or will it prevent the quality of your life from deteriorating? Or is the decision likely to reduce the rate of deterioration of the quality of your life? Will the benefit you are expected to obtain from the decision outweigh the risk of harm to you from an alternative decision?
- a copy of the power of attorney for personal care.
If asked, your attorney is to give a copy of the records to you and to your attorney under a power of
attorney for property.
Your attorney keeps these records until she or he ceases to have authority and gets a legal release, or another person acquires authority to make decisions regarding your personal care and your attorney gives the records to that person, or if you die and your attorney gives the records to your estate personal representative; or on a court order.
How can I express my wishes about how I wish to be treated?
You can do this in writing or verbally. Some people write them down - in what is sometimes called a “living will”. Some people include them as part of their power of attorney for personal care.
What happens if I haven’t appointed an attorney for personal care and I become incapable?
As described above, another substitute decision-maker can refuse or give your consent to medical treatment, admission to care facilities, and personal assistance services. For other personal care decisions, someone, such as a relative, can apply to the court to be appointed the “guardian of your
person”.
What can I do if I believe that an attorney for personal care is acting improperly?
You can apply to the court to replace that attorney for personal care with a court- appointed guardian of the person.