Information for Substitute Decision Makers

Supported Decision Making vs. Substitute Decision Making:


Supported decision making is the process whereby a vulnerable person is enabled to make and communicate decisions and in which advice, support or assistance is provided to the vulnerable person by members of his or her support network.

In substitute decision making, the formally appointed substitute decision maker (SDM) steps in to make the decision(s) in the place of the vulnerable person.

However, substitute decision making should only occur where supported decision-making is not working.

A substitute decision maker formally appointed to make a decision(s) in a certain area on behalf of the vulnerable person has an obligation to continue the process of supported decision-making to the extent possible.

For more information see A Fact Sheet on Supported Decision Making and Support Networks.

What type of decisions can a substitute decision maker make?

A substitute decision maker is given the authority to make only those decisions that are currently before the vulnerable person and that the vulnerable person is unable to make on his/her own or with the assistance of his/her support network.

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 vulnerable person'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:

  • to make decisions regarding the vulnerable person's living arrangements;
  • to make health care decisions on the vulnerable person's behalf;
  • to make decisions regarding the vulnerable person's work arrangements;
  • to make decisions regarding the vulnerable person's participation in educational or life skills training;
  • to make decisions regarding the vulnerable person's participation in social or recreational activities; and
  • to make decisions about daily living activities on behalf of the vulnerable 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 vulnerable person;
  • to receive, deposit and invest money on behalf of the vulnerable person;
  • to pay bills on the vulnerable person's behalf; and
  • to apply for any benefits for which the vulnerable 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.

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 vulnerable person. The substitute decision maker is provided with the original signed Appointment Document and the vulnerable person receives a copy.

This Appointment Document outlines the scope of the substitute decision maker’s appointment and his or her 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 vulnerable person’s property matters.

SDM Duties and Responsibilities

What are the general duties and responsibilities that a substitute decision maker takes on when appointed?

In exercising his or her powers, the substitute decision maker is required to:

 

  • comply with the terms and conditions of his or her appointment;
  • act diligently and in good faith;
  • make reasonable efforts to explain his or her powers and duties to the vulnerable person;
  • seek to foster the vulnerable person's independence;
  • encourage the vulnerable 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 vulnerable person's wishes, values, beliefs and best interests.

A substitute decision maker must also notify the Commissioner in writing of any change in his or her name, address or phone number, and any change in the name and address of the vulnerable person.

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 vulnerable person in those specific areas in which he or she has been given power by the Commissioner and then only where the vulnerable person is incapable of making the decision.

Effect of decision by SDM:

Any decision made, action taken, consent given or thing done by a substitute decision maker in accordance with the Act with respect to any matter within his or her power is deemed for all purposes to have been decided, taken, given or done by the vulnerable person as though the vulnerable person were a capable adult (section 115 of the Act).

Right to Information

A substitute decision maker has the same right of access to information relating to matters for which he or she has authority as the vulnerable person would have if capable. This includes health care information where the SDM 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 his or her 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.