Health Representation Agreement

Health Representation Agreements are valuable for incapacity planning.

A Health Representation Agreement provides you the opportunity to appoint a trusted family member or friend to make your health and personal care decisions when you cannot make these for yourself.

Your representative will oversee your quality of care, or end of life decisions and be your legally appointed personal representative who can advocate on your behalf and manage you through a healthcare crisis or ongoing disease. They will navigate the healthcare system for you. You will always be presumed to have capacity to make your own decisions – until you do not.

Capacity can fluctuate so the personal representative’s decisions made on your behalf will depend on your changing health. If and when they do act, they must always act on your known values and beliefs and step in and make decisions that you yourself would make if you could.

As health can fluctuate and situations be sudden or ongoing, give thought to who you appoint. They should have good critical decision-making abilities to take in information from a doctor and assess that information. They need to weigh possible outcomes combined with what you would value or choose for yourself in the particular situation. They should be able to make urgent, time sensitive decisions and also manage you through a long-term illness such as Alzheimer’s.

Appointing a personal representative of your choice allows you to stay in charge of who makes decisions for you. It defines your hierarchy of health decision makers. In the absence of a personal representative, a family member who you would not want, or who is not capable, to either make decisions or manage healthcare could potentially step forward and begin to make those decisions. For example, you have two daughters, and one could manage you through critical and ongoing illness while the other is too soft to make important or end of life decisions – they might keep you alive at all costs. Or consider a blended family scenario where a spouse and an adult child may both want to make decisions and may not agree or get along. To avoid uncertain decisions for your health, making a health representation agreement allows you to keep control.

Watch our 30-minute education webinar on Health Representation Agreements.

Two Types of Health Agreements

There are two types of agreements available based on different areas of law. Both types are fundamental in that they are designed to enable you to make your own decisions for as long as possible – at the point that support is required or requested by you, then the personal health representative steps in to help you and/or begin making decisions for you. The kind of support the representative can legally offer depends on the document. In British Columbia, the two types of Health Representation Agreements are commonly referred to as Section 7 or Section 9 Agreement.

A Section 9 Health Representation Agreement is for health only and provides the representative the authority to give power up to and including the refusal of life-sustaining treatment. This agreement deals typically with higher level of care needs, but that depends on the situation and capacity of the adult. This is the most common type of Health Agreement and when paired with an Enduring Power of Attorney gives maximum coverage, support, and decision making to you.

If you are not sure if you need a Health Representation Agreement, or how to plan one that meets your needs, please contact our office to discuss your unique situation.

A Section 7 Health Representation Agreement is done when a person has some loss of capacity and provides for assistance with routine financial, health, and personal care decisions. Generally, these are done for adults who have reduced capacity either from birth or through an accident or illness. An Enduring Power of Attorney is the preferred document and must be put in place before reduced capacity occurs. However, if there is enough functional capacity after an accident or illness, this agreement will help for most day to day personal financial or legal matters. This type of Health Representation Agreement can be considered as a backup when an Enduring Power of Attorney was not done. Unfortunately, if capacity is too low for preparing this document, the only option available is to make an application to the court to become an appointed guardian, also known as a ‘Committee.’ This is expensive, cumbersome, and may take many months to complete.

Q&A Health Representation Agreement

Generally, we recommend people who have any of the following reasons to have a health agreement:

  • advanced age
  • known health issues and risks
  • family dynamics
  • blended families
  • age 50+
  • strong values and beliefs around specific healthcare
  • Choose the people you want to make decisions on your behalf.
  • Clear who has decision making ability.
  • Doctors and medical personnel prefer these to be in place so they know who they can talk to and share information with.
  • Representative can be your advocate through complex medical issues.
  • Avoid family dynamics, like family in fighting or disagreements.
  • Appoint the person you trust to support you and uphold your values and levels of care.
  • Someone to make end of life decisions for you.
  • Representative can protect you while you are vulnerable.
  • A trusted family member or friend (does not need to be local).
  • Someone who knows you and your values.
  • Someone who will respect your wishes around level of healthcare.
  • Someone who has had recent contact with you.
  • Someone capable of critical decision making and mental fortitude to manage difficult and long-term decisions.
  • Someone who cares about you and has your back.
  • Someone who can make end of life decisions.

As a rule of thumb, we recommend any one at an advanced age, or anyone with underlying medical conditions to put a representation agreement in place.

It is recommended to give your doctor a copy of your fully signed Health Representation Agreement. It is helpful for your doctor to know who can act on your behalf should something suddenly happen to you. We also recommend that your representative also get a copy. Make sure you never give away the original document unless you want your representative to hold it. We provide copies and scans of all documents upon full and final signing.

Have questions? Chat with us via phone or email.