Please review the following information and complete the short quiz at the end.

Required for Regulated Nurses (RN, LPN, RPN) and HCAs only.  
Carewest supports the rights of clients to make decisions about  their personal care/services and health care treatments. 

Ideally a number of documents are completed by the client in case their capacity is lost or impaired in the future. Carewest supports and provides resources to clients and families about the decision-making options and the importance of choosing and legally appointing someone who can make decisions if they cannot make their own decisions.  

Capacity is defined as the ability to understand information relevant to making a personal decision plus the ability to appreciate the consequences of the decision.

Client decision-making capacity is presumed unless there is reason to believe otherwise or there is evidence to the contrary, at which point screening tools for capacity are used to determine if a formal capacity assessment needs to be completed.

When it has been determined that the client is clearly no longer  capable, ideally the client has one or more of the legal documents described below and a copy filed in the Legal section of their chart. 
A Personal Directive is completed when the client is still capable and names a trusted person to be an Agent for personal decisions including health care. The Personal Directive needs to be enacted when the client has lost capacity. Making a Personal Directive is optional and without one, under the Adult Guardianship and Trusteeship Act, a health care provider may select a nearest relative to make decisions when required for health care or temporary residential placement.

No illegal actions can be documented on the Personal Directive nor can the client indicate that they wish for Medical Assistance in Dying (MAiD) on this document as MAiD can only be initiated by the client, not an Agent. The client also has to be cognitively intact right to the point when the MAiD intervention is provided.

 
Supported Decision-Making

Authorization – if an adult client has the capacity to make their own decisions, but they would like some help, the client can authorize and name a trusted person to be a Supporter for making personal decisions. 

Co-decision Making Order – If a client’s ability to make decisions is significantly impaired, but they can make decisions with good support, a co-decision-making order may be an alternative to guardianship. With the order, the client and their Co-decision Maker make decisions together.

 
Guardianship – If the client lacks capacity, the Court may appoint a Guardian to make personal decisions including health care. Usually a family member or trusted friend applies for guardianship, but if no one is willing or available, the Office of the Public Guardian can perform that role. 

 
An Enduring Power of Attorney assignment is completed when the client is still capable and names a trusted person to be an Attorney for financial decisions.

 
Trusteeship occurs through Court application and names a Trustee (for financial decisions) when the client loses capacity and does not have an Enduring Power of Attorney in place. Usually the trustee is a family member or trusted friend, but the Office of the Public Trustee can be appointed as a last resort.

Who do I contact for more information? 

The Social Worker at your site.
You have completed the overview.  One on the units, you should also be familiar with the policies (located in the Care and Service policies under Legal/Ethics) and familiarize yourself with related forms (Legal and Financial Decision Making Information)

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* 1. First Name in full (as it appears on your application)

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* 2. Last Name (as it appears on your application)

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* 3. Carewest site

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* 4. Unit

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* 5. Clients are able to make their own decisions about personal matters when:

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* 6. An adult can complete a Personal Directive after losing capacity.

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* 7. If a client has completed a Personal Directive, a copy is filed:

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* 8. An adult can write an Enduring Power of Attorney for

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* 9. When a client loses capacity and has not prepared an Enduring Power of Attorney for financial matters, the Court may appoint a 

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* 10. If a client has not written a Personal Directive and has been assessed as being incapable

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* 11. Making a Personal Directive is optional and voluntary.

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* 12. An appointed Guardian can be

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* 13. Where can you find Carewest’s policies on Personal Directives, Guardianship, and Trusteeship?

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* 14. Capacity is defined as

You have completed the quiz. Please note, if you do not get over 80% on the quiz, you need to go back and retake it to improve your results.  
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