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Learning About Substitute Decision-Makers

What is a substitute decision-maker?

An advance care plan lets you decide who you want to make treatment decisions for you if you cannot speak or decide for yourself. The person you choose is called your substitute decision-maker or health care agent.

An advance care plan also lets you write down what kinds of treatment or life support you want or do not want.

What should you think about when choosing a substitute decision-maker?

Choose your substitute decision-maker carefully. This person may or may not be a family member.

Talk to the person before you make your final decision. Make sure he or she is comfortable with this responsibility.

It's a good idea to choose someone who:

  • Is a legal adult in your province. This is usually age 18 or 19 years.
  • Knows you well and understands what makes life meaningful for you.
  • Understands your religious and moral values.
  • Will do what you want, not what he or she wants.
  • Will be able to make difficult choices at a stressful time.
  • Will be able to refuse or stop treatment, if that is what you would want, even if you could die.
  • Will be firm and confident with health professionals if needed.
  • Will ask questions to get necessary information.
  • Lives near you or agrees to travel to you if needed.

Your family may help you make medical decisions while you can still be part of that process. But it is important to choose one person to be your substitute decision-maker in case you are not able to make decisions for yourself.

If you don't fill out the form and name a substitute decision-maker, the decisions your family can make may be limited.

Who will make decisions for you if you do not have a substitute decision-maker?

If you don't have an advance care plan and a substitute decision-maker, your family members may disagree about your medical care. Medical professionals who may not know you as well might have to make decisions for you.

When you name a substitute decision-maker, it is very clear who has the power to make health decisions for you.

How do you name a substitute decision-maker?

You name your substitute decision-maker as part of your advance care plan. This form may be called a representation agreement or a power of attorney for personal or health care. This form may be available through a doctor's office, law office, hospital, senior centre, nursing home, or your provincial or local office for the aging. For more information, talk to your doctor or contact your provincial ministry of health.

Some provinces may require you to get the form notarized. This means that a person called a notary public watches you sign the form and then he or she signs the form. Some provinces may also require that two or more witnesses sign the form.

Be sure to tell your family members and doctors who your substitute decision-maker is.

Keep your forms in a safe place. But make sure that your loved ones know where the forms are. This could be in your desk where you keep other important papers. Make sure your doctor has a copy of your forms.

Where can you learn more?

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