Power of Attorney Form for Personal Care Ontario

DOCUMENT CONTROL AND SPECIFICATIONS

Document Title: Continuing Power of Attorney for Personal Care (Statutory Form - Ontario) Document ID: POAPC-ON-2024-V1.0 Effective Date: [Effective Date] Governing Jurisdiction: Ontario, Canada Statutory Authority: Substitute Decisions Act, 1992, S.O. 1992, c. 30

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STATUTORY & LEGAL COMPLIANCE NOTICE

WARNING TO THE GRANTOR (PRINCIPAL): This document is a significant legal instrument. It grants another person (your "Attorney") the power to make decisions about your personal care, including health care, medical treatment, shelter, nutrition, hygiene, and safety, should you become mentally incapable of making these decisions yourself. This document is drafted in accordance with the Substitute Decisions Act, 1992 (Ontario). You are advised to consult with legal and medical professionals before executing this document. This document does NOT authorize the Attorney to make financial decisions; a separate Power of Attorney for Property is required for that purpose.

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1. PARTIES AND RECITALS

1.1 THE GRANTOR: This Power of Attorney for Personal Care is made by: Full Legal Name: [Grantor Full Legal Name] Principal Address: [Grantor Residential Address, Ontario] (hereinafter referred to as the "Grantor").

1.2 THE ATTORNEY(S): The Grantor hereby appoints the following individual(s) to act as Attorney(s) for Personal Care: Full Legal Name: [Attorney 1 Full Legal Name] Principal Address: [Attorney 1 Residential Address] Relationship to Grantor: [Relationship]

[OPTIONAL: CO-ATTORNEY]: Full Legal Name: [Attorney 2 Full Legal Name] Principal Address: [Attorney 2 Residential Address] Relationship to Grantor: [Relationship]

1.3 SUCCESSOR ATTORNEY (CONTINGENCY): If the primary Attorney(s) is/are unable or unwilling to act, or continue to act, the Grantor appoints: Full Legal Name: [Successor Attorney Full Legal Name] Principal Address: [Successor Attorney Residential Address]

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2. EXHAUSTIVE OPERATIVE CLAUSES

2.1 REVOCATION OF PRIOR POWERS

The Grantor hereby revokes any and all prior powers of attorney for personal care previously executed by the Grantor. This document shall stand as the sole and exclusive instrument governing the Grantor’s personal care decisions upon incapacity.

2.2 SCOPE OF AUTHORITY AND ENGAGEMENT

The Grantor grants the Attorney(s) full authority to make any personal care decision on the Grantor’s behalf that the Grantor could make if capable, except as otherwise limited herein. This authority includes, but is not limited to: (a) Health Care: Consenting to, withdrawing consent from, or refusing any medical treatment, procedure, or medication. (b) Nutrition and Hydration: Decisions regarding dietary requirements and artificial nutrition/hydration. (c) Shelter: Deciding where the Grantor lives, including admission to long-term care facilities or retirement homes. (d) Hygiene and Clothing: Decisions regarding personal grooming and attire. (e) Safety: Decisions regarding the Grantor’s physical security and protection from harm.

2.3 COMPENSATION, REIMBURSEMENT, AND INVOICING

The Attorney(s) shall be entitled to reimbursement from the Grantor’s estate for all reasonable out-of-pocket expenses incurred in the performance of their duties under this Power of Attorney. The Attorney(s) shall maintain an exhaustive ledger of all expenses, supported by receipts. Invoicing for such expenses shall occur on a quarterly basis or as necessary. Pursuant to Ontario law, an Attorney for Personal Care is generally not entitled to compensation for their time unless specifically authorized; the Grantor hereby specifies that: [Insert: "The Attorney shall serve without compensation" OR "The Attorney shall be compensated at a rate of [Amount in CAD] per month/year"].

2.4 TERM AND TERMINATION

(a) Commencement: This Power of Attorney becomes effective only when the Grantor is determined to be mentally incapable of making the relevant personal care decisions, as defined by the Substitute Decisions Act, 1992. (b) Termination for Convenience: The Grantor may revoke this document at any time while they remain mentally capable. (c) Termination by Breach: The authority of an Attorney is terminated upon their death, resignation, or if a court finds the Attorney has breached their fiduciary duty.

2.5 INTELLECTUAL PROPERTY AND PERSONAL INFORMATION

The Attorney(s) shall have the exclusive right to access, manage, and control the Grantor’s Personal Health Information (PHI) under the Personal Health Information Protection Act, 2004 (PHIPA). Any records created by the Attorney in the course of their duties (the "Work Product") shall be held for the benefit of the Grantor.

2.6 MUTUAL CONFIDENTIALITY AND NON-DISCLOSURE

The Attorney(s) shall maintain strict confidentiality regarding the Grantor’s medical condition, personal life, and decisions made under this instrument. Disclosure is permitted only to health care providers, legal counsel, or as required by Ontario law.

2.7 SPECIFIC INSTRUCTIONS (LIVING WILL PROVISIONS)

The Grantor provides the following specific instructions regarding end-of-life care: [Insert specific instructions, e.g., "If I am in a persistent vegetative state with no reasonable hope of recovery, I direct that life-sustaining treatments be withheld or withdrawn."]. If no instructions are provided, the Attorney shall act based on the Grantor's known wishes or in the Grantor's best interests.

2.8 REPRESENTATIONS AND WARRANTIES

The Grantor represents and warrants that they are of the age of majority (18 years or older in Ontario), are of sound mind at the time of execution, and are executing this document voluntarily without duress or undue influence.

2.9 LIMITATION OF LIABILITY AND INDEMNIFICATION

The Attorney(s) shall not be liable for any act or omission taken in good faith while exercising the powers granted herein. The Grantor’s estate shall indemnify and hold the Attorney(s) harmless from any liability, loss, or expense arising from the Attorney’s good-faith performance of their duties, except in cases of gross negligence or willful misconduct.

2.10 DISPUTE RESOLUTION AND MEDIATION

In the event of a dispute between co-attorneys or between the Attorney and a family member regarding a decision, the parties shall first attempt to resolve the matter through formal mediation in Ontario before seeking a court order from the Superior Court of Justice.

2.11 GOVERNING LAW AND JURISDICTION

This Power of Attorney shall be governed by and construed in accordance with the laws of the Province of Ontario and the federal laws of Canada applicable therein.

2.12 MISCELLANEOUS

(a) Severability: If any provision is held invalid, the remainder of the document shall continue in force. (b) Counterparts: This document may be executed in counterparts, including digital versions. (c) Entire Agreement: This document constitutes the entire agreement regarding the Grantor’s personal care representation.

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3. EXECUTION AND FORMAL SIGNATURE BLOCKS

IN WITNESS WHEREOF, the Grantor has signed this Power of Attorney in the presence of the two witnesses named below, who have signed this Power of Attorney in the presence of the Grantor and in the presence of each other.

FOR THE GRANTOR: Signature: _____________________________________ Printed Name: [Grantor Full Legal Name] Date: [Date] Location: [City/Town], Ontario

FOR THE ATTORNEY: I/We hereby accept the appointment as Attorney(s) for Personal Care and acknowledge our fiduciary duties under the Substitute Decisions Act, 1992. Signature: _____________________________________ Printed Name: [Attorney 1 Full Legal Name] Title: Attorney for Personal Care Date: [Date]

FOR THE CO-ATTORNEY (IF APPLICABLE): Signature: _____________________________________ Printed Name: [Attorney 2 Full Legal Name] Title: Attorney for Personal Care Date: [Date]

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4. WITNESS SIGNATURES (MANDATORY IN ONTARIO)

Note: The following individuals cannot witness this document: The Attorney or their spouse/partner; the Grantor’s spouse/partner; a child of the Grantor; or a person under the age of 18.

WITNESS 1: Signature: _____________________________________ Printed Name: __________________________________ Address: _______________________________________ Date: __________________________________________

WITNESS 2: Signature: _____________________________________ Printed Name: __________________________________ Address: _______________________________________ Date: __________________________________________

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5. STEP-BY-STEP EXECUTION & FILING GUIDE

1. Preparation: Open the document in Microsoft Word or Google Docs. Populate all bracketed information [...] with accurate legal names and addresses.
2. Special Instructions: In Section 2.7, be extremely specific about your wishes regarding medical intervention, "Do Not Resuscitate" (DNR) orders, and palliative care.
3. Witnessing: Ensure two witnesses are present physically. Verify they do not fall into the "Excluded Witnesses" category (Attorney, Spouse, Child).
4. Signature Sequence:
   • The Grantor signs first in the presence of both witnesses.
   • Both witnesses sign in the presence of the Grantor and each other.
   • The Attorney(s) sign the acceptance block.
5. Digital Execution: While Ontario’s Substitute Decisions Act allowed for virtual witnessing during the emergency period, it is standard practice for a "wet ink" signature or a highly secure digital platform (DocuSign/Adobe Sign) that complies with the Electronic Commerce Act, 2000 to be used. Note: Virtual witnessing requires at least one witness to be a licensee of the Law Society of Ontario (Lawyer or Paralegal).
6. Distribution: Provide original/certified copies to your Attorney(s), your primary care physician, and your legal counsel.
7. Retention: Store the original document in a fireproof safe or a bank safety deposit box. Notify your Attorney of the location.
8. Review: Conduct an annual review of the document to ensure the appointed Attorneys are still able to serve and the instructions remain aligned with your wishes.