This blog was written by Isabelle Cadotte – Estate and Trust Consultant with Scotia Wealth Management

We’re all familiar with Wills, Enduring Powers of Attorney and Personal Directives but have you heard of Supported Decision-Making Authorizations (SDMAs)?

SDMAs are available in Alberta for adult individuals who have mental capacity but may require assistance from a friend or family member when interacting with health care professionals. It can be particularly useful for individuals who are ill, do not speak English well, are facing a complex personal decision or have mild disabilities.

SDMAs enable adult Albertans to appoint 1 to 3 supporters to assist with a range of personal matters including:

• their health care;
• where, with whom and under what conditions the individual is to live;
• with whom the adult may associate;
• their participation in social activities;
• their participation in educational programs or training;
• their employment; or
• any legal proceeding not primarily related to financial matters.

The individual and their supporter should list which of these matters can be dealt with under the SDMA. Care should be taken to consider not only immediately pressing matters but also matters that are foreseeable and likely to arise in the coming months. They should also indicate how long the SDMA is meant to be in effect – either for a specified period of time (for example, due to an upcoming surgery requiring recovery time and multiple follow-up visits to specialists) or indefinitely (in which case the SDMA would be terminated either by the individual, the coming into effect of their Personal Directive or a court order for guardianship).

The supporter must be 18 years old, have full mental capacity and be a trusted family member or friend of the individual. With a valid SDMA in place, the supporter is authorized to:

1. assist the individual in communicating their questions, concerns and decisions to health care professionals;
2. communicate with health care professionals on behalf of the individual;
3. access, collect or obtain, or assist the individual in accessing, collecting or obtaining their personal information and medical records.

The individual and their supporter can list all or only some of the above powers in the SDMA. For instance, someone who has limited English proficiency may need their supporter to translate for them and communicate on their behalf whereas an individual in an assisted living setting may only need assistance with certain communications.

The supporter must act in good faith and diligently and always with the best interests of the individual in mind. They face no legal liability so long as they conduct themselves in good faith. The supporter must keep a written record of all decisions made or communicated by or with the supporter’s assistance, as well as all relevant details related to their access, collection or disclosure of the individual’s personal information.

Signing an SDMA does not have any effect on a prior Personal Directive. Once a Personal Directive is brought into effect, the SDMA is immediately terminated. If an SDMA is in effect at the time a new Personal Directive is signed, it may be prudent to expressly state in that document that it is not intended to revoke the prior SDMA.

In my practice, I have recommended SDMAs to clients for whom a Personal Directive should not be invoked but who are having more difficulty than before assimilating complex medical information or who may have a physical impairment that affects their speech or mobility. The great strength of family members is that they can summarize or explain complex information in a way that the client will understand more readily, and they can also act as ‘translator’ of the client’s wishes to third parties like medical professionals or lodge administrators. They can also pick up on subtle cues that outsiders may not have noticed. With the SDMA, the client’s stress and confusion is greatly reduced because not only do they have a supporter who “speaks their language”, intimately understands their wishes and is able to communicate them to third parties, but this support person is formally recognized by the third parties with whom they interact. SDMAs help raise the status of family members and friends as essential support persons for vulnerable adults.

Find more information on SDMAs as well as prescribed SDMA forms on the website of the Office of the Public Guardian and Trustee. Also refer to Part 2, Division 1 of the Adult Guardianship and Trusteeship Act, SA 2008, c A-4.2, and the Adult Guardianship and Trusteeship (Ministerial) Regulation, Alta Reg 224/2009, for more information on the SDMA legislative framework.

If you’re in another province and have experience with a similar supported-decision making framework, we’d love to hear your perspective.