Advance Care Planning
What is a Representation Agreement?
Who can make a Representation Agreement?
What is the difference between a Representation Agreement with "standard powers" and one with "enhanced powers"?
How does a Representation Agreement differ from a "power of attorney"?
What is an advance directive (living will)?
What is a "temporary substitute decision maker"?
What is the Office of the Public Guardian and Trustee (OPGT)?
What decisions can a TSDM make?
Q. What should I bring to hospital?
A. Travel light! Personal photo identification is a must if you will be traveling home by air. Bring only the money you think necessary and remember to include travel costs, e.g., taxi, plane or bus. If possible, please do not bring large amounts of jewelry.
Q. How will I get home?
A. It is up to you to arrange transportation. Most patients are not allowed to drive for a period of time after their hospitalization. Please consider taking public transit, having someone pick you up, or booking a flight home. You may not be allowed to go home alone after outpatient surgeries; please check with your surgeon. If you were brought to hospital by ambulance remember that ambulance services are not used to return patients to their homes.
Q. Will I need additional help at home?
A. Preparing your home before coming to the hospital will help to ease the transition back to your house after you are discharged from the hospital. Consider stocking your shelves with non-perishable groceries and leaving your home clean. You might also arrange for someone to assist you if you think that you may need help during your recovery – private-pay home support services are available in most areas. Home medical assistance may be required and will be deemed necessary by your surgeon. If so, community care coordinators at the hospital will make these arrangements with you.
Q. If I do not live close to Vancouver, where can my family stay while I am a patient?
A. Various hotels in the nearby area offer discounted rates to patients and their families. These rates usually vary from season to season. More information about travel and accommodation can be found here. Planning ahead for your personal and financial affairs is also very important.
Currently in British Columbia there is legislation for two types of personal planning documents, which help adults plan for the management of their financial affairs, personal care and health care in the event they become incapable of making these decisions on their own:
1. Representation Agreement
2. Enduring Power of Attorney
For more information on these planning documents and how the might be of use to you, please read the FAQs below.
Q. What is a Representation Agreement?
A. A Representation Agreement allows you to appoint another person to make decisions on your behalf about personal care and/or health care, including matters around where and with whom you will live, and the health care treatment you will receive.
Ultimately, it is a way to ensure that if you need help managing your affairs, you will get it from people you choose and trust. It is also a way to ensure your wishes and values will be honoured.
A Representation Agreement remains in effect if a person becomes incapable.
Q. Who can make a Representation Agreement?
A. Anyone 19 years or older can make a Representation Agreement. Other stipulations apply.
Q. What is the difference between a Representation Agreement with "standard powers" and one with "enhanced powers"?
A. A Representation Agreement with standard powers is an agreement that covers most personal, health care, legal and routine management of financial affairs. You can make the agreement yourself. You do not have to get it notarized and you do not have to go to a lawyer.
A Representation Agreement with enhanced powers is a legal document that requires consultation with a lawyer and notarization. It gives someone permission to make end-of-life and major investment decisions on your behalf, as well as oversight of any businesses you might own.
Q. How does a Representation Agreement differ from a "power of attorney"?
A. A power of attorney, like an enhanced representation agreement, is a legal document. When you give someone power of attorney, you give him or her the legal power to take care of financial and legal matters for you. This might include paying bills, depositing or withdrawing money from your bank account, investing your money or selling your property.
Power of attorney does not give the attorney authority to make decisions about your health care. It covers financial and legal matters only.
A power of attorney automatically ends if you become mentally incapable unless you add a sentence that says you want it to continue. This sentence makes it an “enduring power of attorney.” An enduring power of attorney does NOT address health care or personal care decisions.
Q. What is an advance directive (living will)?
A. An advance directive is a document that allows you to provide in-advance instructions to refuse health care services if you become incapable of making decisions on your own. Unlike representation agreements, advance directives do not require a substitute decision maker to be appointed.
Q. What is a "temporary substitute decision maker"?
A. If you do not have a Representation Agreement or advanced directive and you are not able to speak on your behalf, your health care provider must choose a temporary substitute decision maker (TSDM) to make health care decisions. The law sets out exactly how this is to be done. The health care provider must choose a TSDM from the following list of your family members, starting with:
- a spouse (this includes a same-sex partner and common-law)
- an adult child
- a parent
- a brother or sister
- another relative by birth or adoption
The list of people who can be a TSDM includes your spouse and family members only. If you want someone other than a family member to make health care decisions on your behalf, you must write a Representation Agreement.
If no one from the list is available to be a TSDM or they refuse, the health care provider will ask the Office of the Public Guardian and Trustee (OPGT) to choose someone or act on your behalf.
Q. What is the Office of the Public Guardian and Trustee (OPGT)?
A. The OPGT is a government department that looks after the affairs of people who have no one to help them make decisions.
Q. What decisions can a TSDM make?
A. When you are considered to be incapable, a TSDM can make a decision about major or minor health care but not about other issues like your finances or personal care. The TSDM tool is also "time limited".
Please visit the Representation Agreement Resources Centre website for more information. You can also refer to this page for more information about advance care planning in BC.