From a Health Care Provider
Written by Joanne on April 30, 2013
If a capable adult signs a Representation Agreement appointing one of his or her children as a representative, and there is a disagreement between the adult and the representative, can the family member’s wishes override the wishes of the adult? For example, if an adult’s Occupational Therapist recommends a piece of equipment on discharge from a rehab centre, and the client does not want to purchase this equipment, can the representative then step in, state that it is for the client’s benefit, and sign the form to purchase said equipment regardless of what the client wants?
It would seem to me that if the adult in question is capable, their own wishes should prevail over all other opinions. Would I be correct in this assumption?
Thanks for any information you can provide.
Having a Representation Agreement in place does not prevent the adult from making decisions. Obviously, there could be a situation where an adult’s illness (dementia, mental illness, delirium, etc.) may interfere with their judgment and perception and they are not capable of informed consent. However, that does not seem to be the case here.
Even if the adult cannot give informed consent, and the representative must step up, the first duty of a representative is to check with the adult and their current wishes. People can express their preferences in many ways and the most important role of a representative is to LISTEN – to the adult.
I know my father would sometimes say no to such things because he thought they cost too much. But, my brothers and I did not take the Representation Agreement “out of the drawer” to try and go around him. Rather, we would talk to him about why he did not want to purchase the equipment. If it was because of cost or he thought it was too difficult to manage or whatever, we would problem-solve that issue with him. We might enlist the assistance of the health care team. The best thing is to “put it on the table” with the goal of supporting his wishes, rather than having side conversations.
When trying to convince someone to purchase something for their benefit, it might be helpful to let the adult know that they can change their mind. Perhaps the adult would benefit from a “trial period” with the equipment. Or is it possible to rent it?
I learned that I was often quick to jump at recommendations from the health team – because I wanted the best for my dad – but my dad knew better what would work with his routine and the layout of his apartment. If he didn’t “buy into” a suggestion then it never worked anyway.
I hope this helps. As you can see, I don’t want to make this just a legal question because these are real everyday issues of living.