The Easy Way to Learn About a Health Power of Attorney
(From Someone Who Learned The Hard Way)
by Candace Cleary
If you’ve avoided getting your Power of Attorney affairs in order, you’re not alone. Some find it morbid or tempting fate to even discuss it and many probably think they’re not yet old enough for those kinds of conversations.
In Ontario, Canada, where I live and work, the document (decision-making authority that allows one to make healthcare decisions on behalf of someone else), is legally called a Power of Attorney for Personal Care (POAPC). Depending on where you live, it may be called something else.
For my husband Chris and I, hovering both sides of 40, with a nine-year-old son, we had no idea how soon a POAPC would loom in our lives.
Our experience started with an everyday solo outing on a side-by-side vehicle (imagine an ATV crossed with a dune buggy), and led to a series of life-or-death decisions about Chris’s medical care and challenges to medical opinions. That had to be made by me.
An accidental rollover left Chris pinned under the vehicle for an hour until being discovered by a neighbour who called 911. He was put into a medically-induced coma to check for brain damage and internal injuries, aside from what seemed to be a badly broken arm. I was made his Power of Attorney until he was conscious again.
The good news is that Chris is alive and well and didn’t have to lose his arm. However, at every turn it could have led to a much different ending and I’m sharing our story to illustrate why having a POA in place is imperative.
WHAT IS A HEALTH POWER OF ATTORNEY
One description of POAPC, better described as a Patient Advocate Document, is paperwork
that assigns someone to act on your behalf if you are mentally incapacitated to make
decisions about medical and personal care. It’s essential to choose someone you trust who
knows you well and who understands your wishes regarding healthcare and, if necessary,
end of life care.
In our case, not having a formal POAPC document, the role fell to me as his wife. The broken arm turned out to be extensive muscle, vein and nerve damage, which led to bypass surgery. Chris was kept in the medically-induced coma so they could check the arm every 48 hours. Unfortunately, during that same time period, the odds of his losing his arm would increase, until amputation was inevitable. Doctors and nurses were patient with me as I listened, learned and questioned.
WHAT IF I DON’T HAVE IT IN PLACE?
Medical teams will ask next of kin if a POAPC is in place and then ask one to be determined.
It usually falls to a spouse, parent, sibling or child. If you do not have a POA for personal
care, a family member or friend (who meets the criteria) can apply to the courts for
guardianship. The difference is this: you appoint a POA, but guardianship is appointed by the
courts and of course, this latter route involves time and additional costs. Since every minute
counts in a medical crisis, you want to avoid going through the courts.
Most provincial governments publish Frequently Asked Questions handbooks online and
through provincial government offices. In Ontario, an online link to FAQs for downloading can
When Chris gained consciousness, he pointed to me, saying: “she is my power of attorney.” He knew he was not mentally or physically fit and that I would make careful, informed decisions. From that point, it was written on his chart I had POA for personal care and that all drug and treatment decisions were mine to make.
I learned how to use the My Chart app (available in most hospitals) and followed the advice to never leave the hospital until all my questions were answered. Several times, through some harrowing and life-threatening circumstances for Chris, I just kept thinking: “What if it was me lying in this bed?”It helped steel me to exercise my authority as POA and speak for Chris in preventing his arm from being amputated. Only after ten weeks of crisis and pain management, after Chris had undergone ten surgeries in two hospitals over 100 km apart, were doctors confident Chris wouldn’t lose his arm.
CHOOSING THE RIGHT PERSON
Canadian law prevents certain people from being named POAPC unless that person is also
your spouse; some of which include landlords, healthcare workers, therapists, social workers
or caregivers (of course, only if they are specifically acting professionally in that capacity in
relation to you). If you choose more than one person to act as your POAPC, you have to
specify how decisions are to be made. When two or more attorneys must agree on a
decision, they are said to act “jointly”. When the Power of Attorney document says that they
can make decisions together or separately, they are said to act “jointly and severally”.
It’s a big responsibility that needs a certain type of personality. You need to seriously consider if a person will work well alone or would be better with others. Making team decisions is tough, but having one person making life or death decisions amidst strong-willed dissenters isn’t something you want to put on a person either. You may want to let extended family know your choice in advance.
It’s important to note that the responsibility may be given to a 16-year old child to make
medical decisions for a parent if he or she is the only next of kin. This alone is a good reason
to name a trusted adult in this role so the burden is not put on a child.
Perhaps because of my disposition I was better suited to the task than others would be. I was comfortable asserting my opinion and I questioned medical plans several times along the way, which I firmly believe allowed Chris to keep his arm. When he was brought out of the coma, he was humming songs I had sang to him while I had sat with him for days in the hospital, and it reaffirmed to me that I had to listen to my gut and raise the questions and concerns to best advocate for his care.
EVERY SITUATION IS DIFFERENT BUT I CAN OFFER SUGGESTIONS BASED ON WHAT HELPED ME:
• Up your medical game: Everyone I knew working in the medical field became my teacher.
I researched, learned, asked for translations, built a village.
• Become your own hospital administrator: take photos of healing progress whenever dressings are changed and keep notes on improvements or downturns in recovery and responses to medication. Doctors appreciated having this info bedside rather than recall from memory what they’d seen back on their office desktops along with every other patient’s files.
• Take your role seriously: You may not know what a doctor knows but remember that doctors don’t know what you do about the patient.
• Keep your eye on the long game. Doctors can become focussed on short-term solutions and what may seem inevitable. It’s okay to challenge and ask for alternative prognoses.
CAN A POAPC BE CHALLENGED?
If someone wants to challenge the POA, it goes in front of a court. Someone can challenge a
decision they believe are against the wishes of the patient or aren’t in their best interests.
We’ve all heard anguished stories of families going through the courts about the care of a relative on life-support. It’s a horrible situation no one wants to face. I am grateful that my extended family trusted me in this role.
DO LAWYERS HAVE TO BE INVOLVED?
Consultation with a lawyer is always a wise safeguard. In Ontario, a lawyer is not required,
website of the Office of the Public Guardian and Trustee offers many tools and services and
provides the sensible counsel that “obtaining legal advice in creating these documents is
something you should seriously consider.”
It’s always best practice to contact your legal and financial team before selecting your powers of attorney and ensure everyone is aware of your wishes for both your health and your assets. And yes, you can revoke Health Power of Attorney in the scenario when you regain mental capacity to manage your own decisions.
In our case, power of attorney for personal care was thrust upon me and I took the responsibility seriously, but I didn’t do it alone.
Not surprisingly, I’m now a passionate advocate for choosing a power of attorney for personal care. Having the paperwork in place for both health and finance is an integral component of financial planning.
Information on health POAPCs can be found online through provincial government pages in Canada and state websites in the US.
If you have questions, please reach out to me and I can connect you with the appropriate team member to assist with securing your future wellbeing.
Client Service Specialist
Park Place Financial
Candace began her career in finances in 2015 due to an interest in supporting families in securing their financial futures. Starting as new grad in financial briefs and forensic accounting, in 2017 Candace moved into wealth management. In her support role at Park Place Financial, she enjoys being the first point of contact for clients. Candace has expertise in supporting senior leadership through investigative research, ensuring a holistic approach for planning, prepatory and execution of client needs. Candace is constantly communicating with clients and prides herself in building and maintaining excellent relationships. She finds joy in being able to support clients, allowing her to understand their circumstances, obstacles and goals for the future. Candace lives with her young family in Peterborough, Ontario. She volunteers with a number of charitable organizations there and in her hometown of Sudbury.
Founded in 2012, by Mike D’Alessandro and Darrell Wade, Park Place Financial grew quickly to become one of Central and Eastern Ontario’s top wealth and estate planning firms. Its mission, to be known for excellence in helping grow and preserve the wealth accumulated by family business owners and entrepreneurs across multiple generations. In 2018, Terry Windrem Insurance Agencies joined Park Place Financial, firmly positioning the business as an industry leader in wealth and risk management.