A power of attorney for an elderly parent in BC has to be signed by the parent, while they still have capacity

Which documents does a parent need if their memory is starting to go?

A parent whose memory is changing usually needs an enduring power of attorney for money and property, a representation agreement for health and personal care, in its standard or enhanced form, and an advance directive if they hold firm views about treatment. Each document has its own capacity test, its own signing rules and its own starting point.

Most parents sign a will at the same time; the Wills page covers it. How the four compare:

• Enduring power of attorney (Power of Attorney Act): money, property and real estate, not health care; needs an understanding of what they own and the authority given; signed by parent and attorney with two witnesses, or one lawyer or notary; effective on signing unless it names a later event, and continues through incapacity.
• Standard representation agreement (Representation Agreement Act): personal care, most health care and routine finances; needs only the lower capacity the Act describes; signed by parent, representative and witnesses, sometimes with a monitor; effective on signing and used when the parent can't decide.
• Enhanced representation agreement (same Act): adds decisions such as where the parent lives and refusing life-sustaining treatment; needs an understanding of the authority given; signed with witnesses; effective on signing.
• Advance directive (Health Care (Consent) and Care Facility (Admission) Act): the parent's own consent to, or refusal of, specific treatments; needs capacity for those decisions; signed before two witnesses, or one lawyer or notary; applies when the parent can't consent and a decision is needed.

Can someone with dementia still sign a power of attorney or representation agreement in BC?

Often, yes. A dementia diagnosis doesn't on its own remove capacity. What matters is whether the parent, at the moment of signing, meets the test for that particular document. The bar for a standard representation agreement is lower than for an enduring power of attorney, so a parent who can no longer sign one may still sign the other.

For an enduring power of attorney, the parent must broadly understand what they own and its value, that the attorney can deal with all of it and could misuse that power, and that they can revoke it while capable. A standard representation agreement can be signed even by a parent who can't make the decisions; the Act looks at whether they want the help, can express preferences and feelings, and trust the person named.

Capacity fluctuates, and a clear morning is a legitimate time to sign. The lawyer taking the signature assesses it, usually alone with the parent, with open questions and detailed notes, and may ask for a medical opinion where doubt remains. That opinion is evidence, not a verdict.

What happens if a parent loses capacity without a power of attorney?

If a parent loses capacity with no enduring power of attorney, no family member has authority over their money, and banks won't act on a relative's say-so. The usual routes are an application to the BC Supreme Court under the Patients Property Act to appoint a committee, or statutory property guardianship by the Public Guardian and Trustee.

Committeeship needs medical evidence, normally affidavits from two doctors, and notice to the parent, close family and the Public Guardian and Trustee, which reviews the proposed committee and plan. The court may require a bond, and the committee accounts for its management afterwards.

Statutory property guardianship needs no court: once an assessment under the Adult Guardianship Act finds the parent incapable of managing their finances, the Public Guardian and Trustee becomes property guardian, and a family member can later apply to take over. Both routes cost more and take longer than an enduring power of attorney, and the parent has less say.

For health care, a provider with no representative or committee to ask turns to a temporary substitute decision-maker from a ranked list of relatives in the Health Care (Consent) and Care Facility (Admission) Act, or to the Public Guardian and Trustee.

How do you write an advance directive that doctors in BC will follow?

An advance directive BC health care providers can act on names specific treatments and says whether you consent to or refuse each one, in situations you can foresee. It must be signed and witnessed as the Health Care (Consent) and Care Facility (Admission) Act requires. General wishes, such as 'no heroic measures', give a provider very little to apply.

Name treatments, not just values: resuscitation, a breathing machine, tube feeding, dialysis, antibiotics for a life-threatening infection, transfer from a care home to hospital, each with consent or refusal and the circumstances. Values statements guide a representative or substitute but don't instruct a provider.

The Ministry of Health's My Voice guide includes a form many people use. A No CPR form or a Medical Orders for Scope of Treatment (MOST) form is different: a medical order completed by a doctor or nurse practitioner that tells paramedics and staff what to do on the spot. Many parents need both. Give copies to the doctor, the representative and the care home; a provider can only follow a directive they know exists.

If you have both an advance directive and a representative, whose decision counts?

It depends on how the documents are written. The Health Care (Consent) and Care Facility (Admission) Act sets out when a provider follows a written directive and when it goes to a representative, and a representation agreement can say how the representative should treat the directive. Drafting the two together keeps them pointing the same way.

A representative must follow the wishes the adult expressed while capable, so the two rarely clash when they come from the same conversation. Trouble comes when an old directive meets a newer representative with different views, or the directive is silent on the decision at hand. Review both together.

What does an attorney have to do once they start acting for a parent?

An attorney acting under a BC enduring power of attorney must act honestly and in good faith, in the parent's best interests and in line with their known wishes, values and beliefs. The attorney keeps the parent's money separate from their own, records every transaction, and invests only as the Trustee Act allows unless the document says otherwise.

In practice: an account used only for the parent, receipts for every payment, a running ledger, and decisions that put the parent's needs first, such as keeping them at home if they wanted that and the money allows. An attorney can't make or change the parent's will, and gifts and loans, including to the attorney, are allowed only within the Act's and the document's limits.

Selling the parent's home means meeting the Land Title Office's requirements for using the document, checked before listing. The authority ends at the parent's death, when the executor takes over and the attorney hands over the records; the help for executors page covers what follows.