All adults, even those who are healthy and able bodied, should plan for their care in the event they are incapable of making their own decisions. Planning is even more important if you are injured or if you are living with a chronic illness such as Parkinson’s disease. Your ability to make important decisions may be affected at some point by the physical and cognitive changes common to Parkinson’s disease. It is, therefore, important to make your values, beliefs, and wishes regarding your care known to others.

Representation Agreements allow you to appoint another person (a “Representative”) to make personal care and health care decisions on your behalf in the event that you become incapable of making these important decisions yourself. A Representation Agreement can ensure that your wishes will be respected in such circumstances.

Personal care decisions include where you live, what you eat, participation in social activities, and contact or association with other people.

Health care decisions include matters ranging from routine tests and dental treatment to major surgery, and diagnostic, and investigative procedures. A health care decision can include consenting to or refusing treatment. 

Advantages of a Representation Agreement

The advantages of a Representation Agreement are:

1. You can designate who your Representative is. You have the choice of appointing a single Representative or multiple Representatives. If you appoint multiple Representatives you can designate whether they may act alone or must act together. You may also designate an Alternative Representative who will act if your Representative(s) cannot act or continue to act for you
2. You can designate the scope of the Representative’s authority to make decisions on your behalf;  
3. As long as you have the capacity to, you can revoke your Representation Agreement; and
4. No independent selection processes are necessary to appoint someone as your Representative.  

Temporary Substitute Decision Maker

If a health care decision needs to be made for you and you are incapable of making the decision on your own behalf and you have not appointed a Representative under a Representation Agreement, your health care provider may appoint a Temporary Substitute Decision Maker for you. A health care provider must appoint the first available person, in order, from the following list, to obtain necessary consents to, or refusals of, treatment:

• your spouse
• your child
• your parent
• your brother or sister
• your grandparent
• your grandchild
• anyone else related to you by birth or adoption
• a close friend
• a person immediately related to you by marriage

The first qualified person contacted who agrees to make decisions on your behalf becomes your Temporary Substitute Decision Maker. If, in the opinion of the health care provider, there is no available and qualified person, or there is a dispute about who is appointed, the Public Guardian and Trustee will step in and either appoint a person as your Temporary Substitute Decision Maker or act as your Temporary Substitute Decision Maker. The Temporary Substitute Decision Maker may not be the person you would ordinarily appoint to make your health care decisions.

Disadvantages associated with having a Temporary Substitute Decision Maker include:

• there can only be one Temporary Substitute Decision Maker at any time, whereas a Representation Agreement allows you to appoint multiple Representatives;
• a Temporary Substitute Decision Maker has no authority to make decisions regarding your personal care or to give or refuse consent to a serious health care decisions; and
• a Temporary Substitute Decision maker has very limited ability to refuse consent to health care that is necessary to preserve life.

In contrast, a Representation Agreement allows you to appoint a person you trust to provide care based on your wishes and instructions without the delays, complications or limitations of a Temporary Substitute Decision Maker.

Types of Representation Agreements

There are two different types of Representation Agreements:

• A Standard Representation Agreement, which gives your Representative the power to make routine decisions regarding personal care and health care, as well as routine management of your financial affairs such as paying bills and basic banking transactions; and,
• A Non-Standard Representation Agreement, which gives your Representative the power to make any type of personal care or health care decision that may affect you, including the power to refuse life supporting care or treatment on your behalf.

While all Representation Agreements allow you to specify the types of personal care and health care decisions that may be made on your behalf, the extent of the powers that can be granted to your Representative under a Standard Representation Agreement are much more limited than those that can be granted under a Non-Standard Representation Agreement. For instance, a Representative under a Standard Representation Agreement has very limited authority to accept a care facility proposal, and cannot refuse life-supporting care. In addition, Standard Representation Agreements generally require the appointment of another person, called a Monitor, to oversee the activities of your Representative. 

Do you need a lawyer to make a Representation Agreement?

While a lawyer is not required to make a Representation Agreement, it is helpful to consult a lawyer who can help you understand the wide range of issues and create a Representation Agreement that meets your needs.

Can you register a Representation Agreement?

At the Nidus Personal Planning Resource Centre & Registry, you can register both Enduring Powers of Attorney and Representation Agreements. For more information, please visit their website at www.nidus.ca.

Helpful Resources

• The Public Guardian and Trustee of British Columbia has detailed information on Enduring Powers of Attorney, Representation Agreements and other important topics. You can contact them at 604 660 4444 or visit their website at www.trustee.bc.ca. 
• The Nidus Personal Planning Resource Centre & Registry provides detailed information on Representation Agreements. You can contact them at 604 408 7414 or visit their website at www.nidus.ca. 
• The Government of British Columbia’s website, https://www2.gov.bc.ca/gov/content/health/managing-your-health/incapacity-planning, provides information on incapacity planning, including forms that can be used. Please note that it is still recommended that you consult a lawyer, as the forms provided by the Ministry may not be appropriate for use by all persons and the Ministry does not provide legal advice. 
• Dial-A-Law© is a library of legal information that is available by phone, as recorded scripts, and by audio and text. You can contact them at 604 687 4680 in the Lower Mainland or 1 800 565 5297 elsewhere or visit their website at www.dialalaw.org. 
• People’s Law School offers public legal education and information. You can contact them by phone at 604 331 5400or visit their website at www.peopleslawschool.ca.

Prepared by Blake, Cassels & Graydon LLP. Last updated: October 8, 2025