Guest author: Nicolas Methot, Social Worker, Broadmead Care
We all like to be in charge of our own decisions. But what happens when someone loses this ability? When people get older or face health challenges, they may need some extra help in making decisions about their money and health. In British Columbia, there is a system in place to make sure they get the right support. This system helps make choices about finances (money) and health (medical) when someone is not able to do it themselves.
You may have heard the terms ‘Substitute Decision Maker’ and ‘Power of Attorney’. Both are forms of substitute decision makers, representing two very different aspects of someone’s life.
A Power of Attorney (POA) provides financial decisions, whereas a Substitute Decision Maker (SDM) provides or advocates for healthcare or medical issues. In British Columbia, unlike some other provinces and territories in Canada, requests for substitute decision making take into account two factors:
- whether the matter at hand is financial or medical; and,
- whether there were legal arrangements made prior to the individual becoming incapable.
Let’s take a closer look.
Financial Decision Making
Imagine you have saved up some money over the years, and you need to make important choices about how to use it. But what if you become unable to make these choices? In British Columbia, there are laws that allow someone to step in and help. They could be a family member, a close friend, or even a legal representative.
For example, let’s say Geneva is finding it hard to understand her bills and manage her bank account. Geneva needs help. She might ask a family member or a close friend to help manage her financial matters. This person would make sure Geneva’s bills are paid, her savings are managed, and her financial needs are taken care of properly.
Financial decision making is most commonly handled by an Enduring Power of Attorney document. This is a document that gives another individual permission to make financial transactions as if they were you. This document:
- Must be signed while someone is still capable of managing their own finances.
- Is in effect from the time that it is signed.
- Continues to remain in effect after the person is assessed by a medical professional as being incapable of managing their own finances.
Note that if Geneva had been assessed as incapable before she signed a POA agreement, she would not be able to enter into a POA agreement. But she would have alternatives; she and her loved ones would need to look at those options, through discussions with their lawyer or other advisor.
For more information about the Power of Attorney document, or the processes surrounding it, please consult your lawyer or financial advisor. You can also find more information through these links:
Medical Decision Making
Health is really important, and sometimes people might not be able to make choices about their medical treatments. That’s where substitute decision making comes in. If someone can’t say what medical care they want or need, a Substitute Decision Maker (SDM) can step in and make those choices based on what they know about the person’s wishes.
For instance, suppose Orville lives in one of our Homes, and suddenly becomes very sick. He can’t talk to the Care Team and tell them what he wants. In this situation, his SDM would step up to help.
While there is legislation that helps automatically determine the most appropriate substitute decision maker for Orville, if he has someone specific he trusts to take on this role for him, he can sign a formal representation agreement naming them as his SDM, while he is still able to make this decision.
This person would talk to the Care Team, ask questions, and make decisions about Orville’s medical care based on what he would have wanted. The SDM would consider past conversations with Orville, and his beliefs and values, to make the best choices for his health.
British Columbia does not recognize a permanent state of ‘medical incapacity’ outside of court-ordered adult guardianship. In British Columbia, healthcare providers are to start by assuming that every adult is capable of making their own medical decisions, even if the person has previously been assessed as not being able to make these decisions.
Substitute decision making for medical issues is complicated, and we’re not experts, so please speak with your healthcare provider, lawyer, or other qualified advisor, for more information.
You can also find more information and fact sheets at the following links:
The information on this page is not legal or financial advice. Broadmead Care encourages donors to contact their professional advisors about estate planning matters.
