“My sister Janis has an intellectual disability. The people who are close to her have always helped her to make decisions. Janis formalized her support arrangement by signing a standard representation agreement. Her supportive decision-makers all care for her deeply. Sometimes we get together as a group to talk with Janis about her decisions.”
– Carly, New Westminster, BC
A person with limited or declining capacity may be able to sign a standard representation agreement. They’re often referred to as section 7 representation agreements. An adult who needs help now can choose someone they trust as a representative. This person can support them to make decisions about financial, legal, health care, and personal care matters.
The relationship that a standard representation agreement describes is recognized by the law. This means that outside parties (such as banks and doctors) must, under the law, respect the arrangement.
Eight reasons why someone may want a standard representation agreement
“My mother Tram has just been diagnosed with Alzheimer's. She made me her representative. She’s always been fiercely independent. She hopes she’ll be able to make her own decisions for some time yet, with support from me as needed. We know the time will eventually come when she’ll need me to make decisions for her. We talked about her goals, beliefs, and values. When needed, I can make decisions based on what she would have wanted.”
– Khoa, Abbottsford, BC
The law recognizes that everyone has the right to meaningfully participate in decisions that impact them. This is where supported decision-making comes in. It’s not about taking over and making decisions for someone. It’s about helping them find their way to their own solutions.
The law says that when helping an adult to make a decision, a representative must consult with them about their wishes, and comply if it’s reasonable to do so.
Supported decision-making may be the right fit
“Chella is non-verbal. But that doesn’t mean she can’t tell me what she wants. Often, I’ll explain Chella’s choices to her by role playing different scenarios. I ask her yes and no questions. She’s able to express her wishes by making certain gestures and noises.”
– Zadie, Vancouver
Supported decision-making may be helpful for:
adults with intellectual disabilities surrounded by an engaged and committed circle of support,
ageing adults experiencing the early stages of cognitive decline, and
adults for whom it’s a cultural norm to make communal decisions with their family.
It’s important to be aware of “slippage.” The term describes a situation where someone is misrepresenting their care of a vulnerable adult. They're saying the relationship is collaborative, when in fact they’re taking unilateral control of making decisions.
Supported decision-making may not always be possible or appropriate
Supported decision-making may not be a good fit for those:
who don’t have anyone close to them in their life,
with fluctuating cognitive abilities, or
in the later stages of dementia, or another degenerative disease.
For example, an adult’s condition may deteriorate after they’ve made the agreement. They may truly lose the capacity to make decisions of any sort. If this happens, a representative’s authority continues. At this point, it may be impossible to consult with the adult. The representative would need to take over decision-making for the adult.
What if it's not reasonable to consult with an adult about their wishes (what they want)? A representative is still required, by law, to make decisions that align with the adult’s known beliefs and values (what’s important to them).
The law sets out one of the main reasons for preparing a standard representation agreement — to avoid the need for the court to get involved.
No one has the automatic authority to make legal, financial, or even personal care decisions for someone who is incapable of making the decision themselves. As a last resort, a family member or friend may need to apply to court to get the authority to become committee. There are two types of committees.
A committee of person becomes responsible for making decisions about an adult’s health and personal matters. One may be appointed when:
a major health care decision or action needs to be made on someone’s behalf,
there’s no representation agreement or advance directive in place, and
a temporary substitute decision-maker can’t be located or there’s a family disagreement.
A committee of estate becomes responsible for making decisions about an adult’s financial and legal affairs. One may be appointed when a major or complex legal or financial decision or action needs to be made on someone’s behalf and a representation agreement or power of attorney isn’t in place.
Going to court is rarely a desirable Plan A. It’s expensive and time-consuming. It can cause unnecessary stress for the adult, their family, and others close to them. It can take months or even years for applications to be heard in court. This can delay access to money needed for the adult’s care and degrade their quality of life.
Before appointing a committee, the court must declare you incapable. This declaration strips an adult of their decision-making rights over their body and property. On the other hand, representation agreements emphasize an adult’s right to self-determination.
The Public Guardian and Trustee can be appointed as committee. This may happen when a committee is needed but there’s family conflict or no one else steps forward to apply as committee.
If someone is incapable of consenting to health care treatment, someone else will need to make the decision for them. There’s a hierarchy of authority that a health care provider must follow if a decision needs to be made and they’re not able to make it. At the bottom of the hierarchy is a temporary substitute decision-maker.
This person will be temporarily appointed to make a specific health care decision for the adult. They’ll only be called on if there’s no other authority (such as a representation agreement) in place that addresses the specific health care need.
A temporary substitute decision-maker is not someone chosen by the adult. It may be someone they never would have wanted to make a decision about their health for them. See the section “Understand your legal rights” on our page about temporary substitute decision-makers to learn more about who might be chosen and what they’ll be asked to do.
For an adult who needs help right now, preparing a standard representation agreement serves two purposes:
They can plan for the future. Who do they want to take care of them when their current caregiver(s) aren’t around?
They can formalize their care relationships, and get the immediate help they need.
In practice, caregivers often make decisions for adults with disabilities without the legal authority to do so. These arrangements could be legally challenged. Standard representation agreement can formalize existing caregiving relationships.
Helping your family member or friend plan is an investment in their future — and in their life right now. Thinking ahead together is a validating experience. It makes them feel heard and understood. The peace of mind that comes from having one’s preferences and values respected is part of living a good life.
A standard representation agreement can be tailored to fit an adult’s preferences and circumstances. For example, they can choose:
Different people to make different kinds of decisions: Sam can make routine financial decisions and legal decisions for Ron. Jo can make health care and personal care decisions for Ron.
Two or more people to make the same kind of decision: Sam and Jo can make health care decisions together for Ron. In this scenario, they must act unanimously unless the agreement gives them permission to do otherwise.
Employees of care facilities and other paid staff cannot be representatives. This is a role for family members and friends.
“Our son Phil had a ski accident. His head hit a rock — hard. We’ve been caring for him since, but know we won’t live forever. Phil chose his brother Marvin as his alternate representative. Marvin knows how Phil communicates, he knows his likes and dislikes, and he knows how to make him laugh! Phil can continue getting the support he needs after we’re gone.”
– Etta, Burnaby, BC
An adult can choose a representative to help them make decisions. It’s always a good idea to name an alternate representative — someone who can step in if the first representative is no longer willing or able to help.
If you are caring for an adult now: you might not always be able to care for someone who depends on you. A standard representation agreement can ensure that their needs will continue to be met.
Planning together for an adult’s care, with the adult, can strengthen the connections between family, caregivers, and those close to them.
Here are just a few of the benefits of planning:
When everyone understands their role in the network of care, there’s less chance of conflict.
The likelihood of disputes among family members — over things like who should pay for what — is likewise minimized.
A representative (including alternates) can take the time to learn what works best for the adult and what doesn’t.
Together, both the adult and their representative can learn about the options available to them. A representative can help an adult learn more about:
their health issues and what their medical needs might be going forward,
possible living arrangements, programs and activities they can participate in,
government benefits they might be entitled to, and
Casting a wide information-gathering net will help the adult make informed decisions. It’s comforting to have had the chance to think things through in advance. Failing to plan for future care may have a number of consequences. Among them:
inadequate input of the adult about their own future,
inappropriate care arrangements and facility placements,
inadequate legal and financial safeguards,
disagreements among family members and with care providers, and
increased confusion for the adult.
Standard representation agreements are designed for adults who need help now because they’re incapable of making decisions independently. They may be appropriate for an adult:
with an intellectual disability,
who suffered from a traumatic brain injury,
experiencing age-related mental decline, or
whose cognitive function is otherwise impaired due to illness or accident.
There are also some circumstances where an adult who can make decisions independently might choose to make one.
We are grateful to work on the unceded traditional territories of the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish) and səlilwətaɬ (Tsleil-Waututh) Nations, whose Peoples continue to live on and care for these lands.