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Why do I need a Representation Agreement for health care if I have a spouse and adult child? Are they not the default?

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Written by Joanne on June 27, 2013

Dear Joanne,

I do not need any help at this time, but I want to plan for the future and possible incapacity, so I am looking at the Representation Agreement Section 9 for health care. I already have a formal Power of Attorney done for myself and my wife to cover our financial affairs.

My question is, do I really need an RA9? I simply want my wife to be my representative if I am incapacitated and my adult son as the alternative. But I assume that this is the default even if I do not have an RA? So I would think that I do not need an RA. Do you agree?


Nidus recommends that people make a Representation Agreement to cover health care and personal care matters, rather than leaving it to the ‘default scheme.’

The reasons are similar to those for making a Will. You do not have to make a Will; the money will be divided among your spouse and children. But it may not be divided up the way you would like and depending on the amount of money involved, there are numerous extra fees when there is no Will.

By making the RA9, you are being pro-active. It gives you more control, it makes things easier on your wife and son and it avoids the involvement of outside parties and possible extra costs.

If you do not make a Representation Agreement and you become incapable of consent for medical treatment, the doctor and other health care providers will select someone to be your ‘Temporary Substitute Decision Maker’ (TSDM). The Health Care Consent Act lists who can be a TSDM.

The first on the TSDM list is a spouse. Next on the list is an adult child. If you have more than one child, the doctor can select whichever one they wish.

A TSDM only has authority to make health care decisions. They do not have authority to make decisions about your personal care (living arrangements, diet, grooming, spiritual matters, etc.). Personal care matters often become very important if you develop a chronic illness or condition such as Parkinson’s or dementia and need facility care.

A TSDM’s authority is ‘temporary.’ If a health care provider determines you are incapable and a decision needs to be made, then they call on a TSDM.

However, in the case of a Representation Agreement, your representative does not need to wait to be ‘called on’ to make a decision. They can be advocating for your care – asking questions and providing information to the medical team. A representative can help you at any time, with health care AND personal care matters.

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