Information for Substitute Decision Makers

Supported Decision Making vs. Substitute Decision Making

Supported decision making is when an adult living with an intellectual disability relies on friends, family, and community to help them communicate and make decisions. An adult living with an intellectual disability may rely on their support network to provide advice, support or assistance. Supported decision-making is less formal than substitute decision-making.

In substitute decision making, the formally appointed substitute decision maker (SDM) is empowered to make decision(s) on behalf of the adult living with intellectual disabilities. However, even when a substitute decision maker is appointed, they must respect the principles of the act and include the person for whom they are making decision as much as possible. A substitute decision maker formally appointed to make a decision(s) in a certain area on behalf of the adult living with an intellectual disability has an obligation to continue the process of supported decision-making to the extent possible.

The appointment of a substitute decision maker is a last resort. Substitute decision making should only occur where supported decision-making is not working. For more information see A Fact Sheet on Supported Decision Making and Support Networks.

 

Substitute Decision Maker Duties and Responsibilities

In exercising their powers, the substitute decision maker is required to:

• comply with the terms and conditions of their appointment
• act diligently and in good faith
• make reasonable efforts to explain their powers and duties to the adult living with an intellectual disability
• seek to foster the person's independence
• encourage the person to participate in the substitute decision maker's decision
• choose the least restrictive and least intrusive course of action available in a situation; and
• take into consideration the person's wishes, values, beliefs and best interests. A substitute decision maker must also notify the Commissioner in writing of any change in their name, address or phone number, and any change in the name and address of the  person for whom they are the decision maker.

What type of decisions can a substitute decision maker make?

A substitute decision maker is only given the authority to make those decisions that are currently before the adult living with an intellectual disability and that they are unable to make on their own or with the assistance of his/her support network. Support network.

A substitute decision maker is appointed when a decision is necessary. An application may not be accepted if there is no specific decision that needs to be made. In other words, the commissioner does not appoint substitute decision makers "pre-emptively."

The powers that may be granted by the Commissioner are divided into two major areas – personal care and property. An applicant can propose that a substitute decision maker be appointed for the management of the adult living with an intellectual disability's personal care, property, or both personal care and property.

1) Personal Care

Some of the powers that may be granted to the substitute decision maker for personal care are:

• decisions regarding the person's living arrangements;
• health care decisions on the person's behalf;
• decisions regarding the person's work arrangements;
• decisions regarding the person's participation in educational or life skills training;
• decisions regarding the person's participation in social or recreational activities; and
• decisions about daily living activities on behalf of the person.

2) Property

Some of the powers that may be granted to the substitute decision maker for property are:

• to purchase, sell, dispose of or transfer personal belongings on behalf of the person;
• to receive, deposit and invest money on behalf of the person;
• to pay bills on the person's behalf; and
• to apply for any benefits for which the person may be eligible.

For more information and a full list of the powers that may be granted see pages 7, 8 and 9 of the

Guide to Completing a Substitute Decision Maker Application.

 

In general, what authority does the substitute decision maker have?

Scope of authority

A substitute decision maker has the legal authority to make decisions for the person in those specific areas in which they has been given power by the Commissioner and then only where the adult living with an intellectual disability is incapable of making the decision.

Effect of decision by the substitute decision maker

In the act, a substitute decision maker is empowered to act on behalf of the adult living with an intellectual disability.  A decision made by a substitute decision maker on behalf of an individual is treated as though the individual made it themselves as a capable adult. 

Right to Information

In their area of decision making, a substitute decision maker has the same right of access to information as the adult living with an intellectual disability would have if they were a capable adult. This includes health care information where the substitute decision maker has been granted the power to make health care decisions. The substitute decision maker also has the right to consent to the release of that information to another person.

Can a substitute decision maker be held liable for decisions made or actions taken?

Yes, a substitute decision maker for property is liable for damages that result from a breach of their duty under the act. However, if determined by a court that the substitute decision maker nevertheless acted honestly, reasonably and diligently, they may be relieved from all or part of the liability.

How do I prove my authority as a substitute decision maker?

The Appointment Document issued by the Commissioner is the legal document that the substitute decision maker will use to provide verification of their role and authority to make a decision or decisions on behalf of the adult living with an intellectual disability. The substitute decision maker is provided with the original signed Appointment Document and the adult living with an intellectual disability receives a copy.

This Appointment Document outlines the scope of the substitute decision maker’s appointment and their specific authority. Below is a sample of a substitute decision maker’s Appointment Document for personal care. An Appointment Document for property would look similar but would be specific to the area of managing the adult living with an intellectual disability’s property matters.

• Appointment Document (sample)