This blog post was written by: Dave Madan, Senior Manager, Scotiatrust

Dementia is not just a medical diagnosis; it’s a family story that unfolds over years. Canada’s numbers are climbing—projections suggest more than 1.7 million Canadians could be living with dementia by 2050. That’s a lot of spouses, adult children, and friends carrying new responsibilities—and often facing urgent decisions. The simplest way to bring calm to those moments is to have the right document in place before a crisis: a Power of Attorney (POA). (Alzheimer Society of Canada.) 

Across Canada, there are two main decision-making roles to consider, though the names vary by province. One covers money and property: in Ontario it’s a Continuing Power of Attorney for Property; in Alberta it’s an Enduring Power of Attorney; in B.C. it’s an Enduring POA under the Power of Attorney Act. The other covers care and health decisions: Ontario uses an Attorney for Personal Care; B.C. uses a Representation Agreement; Alberta uses a Personal Directive. Québec is different: a single Protection Mandate (mandat de protection) covers both property and personal care and must be homologated by the court to take effect. (See Ontario’s Substitute Decisions Act and Health Care Consent Act; B.C.’s Power of Attorney Act and Representation Agreement Act; Alberta’s Enduring POA and Personal Directive; Québec’s Protection Mandate.) 

Timing matters. POAs (or the Québec mandate) must be made while the person still has legal capacity – that is, they understand the nature and consequences of what they’re signing. Early in the dementia journey, many people still meet that threshold. Waiting can mean losing the option to name your own decision-maker and having to pursue court routes (guardianship/trusteeship, or in Québec, mandate homologation). Ontario’s guidance on making a POA is a good, plain-language starting point. (Make a power of attorney – Ontario.) 

Families sometimes hesitate, worrying a POA hands over control too soon. Properly drafted, it doesn’t have to. Many POAs are effective immediately or “spring” upon a specified event or assessment; Representation Agreements and Personal Directives can also be tailored to wishes and values rather than just tasks. In B.C., for example, the health-care decision framework sits within the Health Care (Consent) and Care Facility (Admission) Act – and if no representative is available, clinicians follow a legally ranked “temporary substitute decision-maker” (TSDM) list. (HCCCFAA – B.C. law; PGT guide for TSDMs.) 

Duties and safeguards matter just as much as naming the right person. Attorneys and representatives must act honestly, follow known wishes, and keep proper records. B.C. even codifies record-keeping for attorneys in regulation—baseline inventory of assets and liabilities, ongoing accounting, etc. Ontario’s health-care law requires substitute decision-makers to honour prior capable wishes; if none are known, act in the person’s best interests considering values and beliefs. (See B.C.’s Power of Attorney Regulation and Ontario’s HCCA s.21.) 

If you’re supporting a client, or a loved one, think of POAs as a recipe for keeping the peace. Clear authority prevents the “who decides?” arguments that often flare during care transitions or when finances change (selling a home, hiring caregivers, managing investments). Where no document exists, systems fill the gap, but not always in the way families expect: in B.C., for instance, providers must choose a TSDM from the statutory hierarchy; if no one qualifies, the Public Guardian and Trustee can authorize someone or step in as a last resort. (Consent to health care & the role of the PGT – B.C..) 

A quick, practical checklist:

• Have both instruments (money/property and personal/health) or, in Québec, a Protection Mandate ready.

• Document capacity at signing and, if using a “springing” clause, specify how incapacity will be determined.

• Clarify scope: banking, investments, real property, business interests, and care preferences; for health, note wishes and values clearly.

• Name alternates and include reporting/accounting expectations (e.g., annual summaries).

• Plan communication: share the “who/what/when” with close family and care teams early; keep copies accessible.

• Review regularly—after a diagnosis, a move, a new caregiver, or every few years.

None of this removes the emotions that come with dementia. But having the right documents and the right people named, creates space for families to focus on care and dignity, not paperwork and conflict. If your clients or loved ones do one thing, let it be this: talk about wishes while conversations are still easy, then put them in writing.