Who will Speak for You? Representation Agreements
Regardless of age and health status, every adult should strongly consider formally naming a trusted person (spouse, family member, friend) in a Representation Agreement to speak for them in the case of serious illness, injury, or cognitive decline.
Representation Agreements allow your Representative to assist you while you are capable (but only upon your express consent) and are only legally in force when you are incapable of making your own decisions…
Under the law, you are presumed capable. You can continue to make decisions until you are incapable of making these decisions.
~Public Guardian and Trustee
Having a Representation Agreement in place – and having it immediately available for first responders and front-line staff – will allow a person you trust to speak for you at the most vulnerable (and probably worst) moment of your life.
Your Representative doesn't have to be a relative. It can be a neighbour or a friend.
Your representative is concerned with all aspects of your future personal and medical care.
Having a Representation Agreement is the only way to appoint someone to act on your behalf for your health care and personal care matters, such as where you will live, special dietary or clothing needs, and additional help with daily living should the need arise.
A powerful document calls for courageous conversations.
If you are writing your Representation Agreement, also have courageous conversations about your preferences for care. Read: Understanding Resuscitation and Levels of Care.
If you are the SDM or Representative, take the time to ask what is important to your loved one for a time when they approach the end of life.
Representatives are Care Partners
They are fundamental members of your team:
They are your eyes, ears and voice when you cannot speak for yourself.
They are the deliverers of your history, values, beliefs, and healthcare preferences.
Choose your Representative with thought.
Take a moment to consider:
In times of stress and difficulty, who provides you with support? Why?
If you could not direct your own medical care, who would you want to make these decisions for you?
Your Representative doesn't have to be a relative. It can be a neighbour or a friend.
It should be someone who:
Is willing to do the job.
Can speak assertively.
You trust to carry out your healthcare wishes.
Can make tough decisions.
Your Representative can live anywhere, but they should be available by phone and able to travel to be at your side.
You are encouraged to name an Alternate Representative who can step in if your Representative is unavailable due to significant cause.
Considerations if you want your spouse to be your Representative
Are they in good physical and mental health? This is often a tough job and will require stamina.
Will they be able to stay logical when it’s an emotionally charged situation?
Will they be able to make tough decisions?
Will they want to be your spouse, holding your hand and providing comfort?
If you want your spouse to be your Representative and they are getting older, consider having another person as co-Representative. This requires a custom form. Contact Nidus or a Notary Public or estate lawyer.
A summary of the two kinds of Representation Agreements:
Representation Agreement Section 7 (RA7): two types.
Representation Agreement Section 9 (RA9): This should be considered the first choice for all capable adults.
Representation Agreement Section 7 (RA7)
Basic RA7 is for HEALTH & PERSONAL only.
It is for those with an Enduring Power of Attorney who only need personal and health assistance.
Examples:
When the capability of decision-making is in question (mental health issues or early to moderate dementia). The adult may be unable to handle their day-to-day decisions, but they can identify the person they trust to make decisions.
When you're assigning someone you trust (a neighbour or friend), but you don't know them well enough to trust them to make the really big decisions.
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RA7 ALL is for Health, Personal + Financial & Legal.
It can be used by those whose ‘capability’ is in question. The Representative cannot make major financial decisions, can’t make end-of-life decisions, and is restricted regarding personal care and residential care decisions. The Representative has a modified and restricted Enduring Power of Attorney to make simple financial decisions but cannot transfer money or assets or close accounts. (Use caution: many major financial institutions don't recognize or don't acknowledge these documents.)
Examples:
You have mild to moderate dementia. You are having difficulty managing some day-to-day tasks, but you know who you want to help understand your medical situation; you want them to help you with your personal tasks, and you want to help you with your regular bills.
You live alone and have no family readily available. An RA7 with Financial will allow a friend or neighbour to assist you with your healthcare and personal decisions and enable them to manage your regular bills.
Representation Agreement Section 9 (RA9)
RA9 is for HEALTH & PERSONAL only: it has no financial component.
It should be the type of Representation Agreement strongly considered for all capable adults. It is the most powerful health document.
The Representative can assist with routine matters while you are still capable and make all decisions when you are incapable.
An Enduring Power of Attorney is highly recommended for Financial and Legal affairs. The Representative can also be the EPOA, requiring two separate documents.
