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Power of Attorney for Personal Care (Canada)

Power of Attorney for Personal Care (Canada)

POWER OF ATTORNEY FOR PERSONAL CARE

This Power of Attorney for Personal Care (the "Power of Attorney") is made as of [Date] by:

[Grantor Name], born [Grantor Date of Birth], of [Grantor Address] (the "Grantor")

RECITALS

A. The Grantor is capable of personal care within the meaning of the applicable provincial legislation and wishes to appoint an Attorney to make personal care decisions on the Grantor’s behalf if the Grantor becomes incapable of making such decisions personally.

B. Under the applicable legislation of the Province of [Province], “personal care” includes healthcare, nutrition, shelter, clothing, hygiene, and safety.

C. The Grantor understands the nature of this Power of Attorney, the authority being granted, and the consequences of signing this document.

NOW THEREFORE, the Grantor declares and directs as follows:

1. APPOINTMENT OF ATTORNEY FOR PERSONAL CARE

1.1 The Grantor hereby appoints [Attorney Name], of [Attorney Address], phone: [Attorney Phone] (the "Attorney"), who is the Grantor’s [Attorney Relationship], as the Grantor’s Attorney for Personal Care.

1.2 The Attorney, by signing this Power of Attorney, acknowledges and accepts the appointment and agrees to act honestly, in good faith, and in accordance with the Grantor’s wishes as expressed in this document and any other wishes the Grantor expressed while capable. Where the Grantor’s wishes are not known, the Attorney shall act in the Grantor’s best interests, having regard to the Grantor’s values, beliefs, and known preferences.

1.3 The Attorney’s authority under this Power of Attorney is effective only when the Grantor is incapable of making personal care decisions. The Attorney has no authority to make decisions on the Grantor’s behalf while the Grantor is capable of making those decisions personally. If the Grantor regains capacity, the Attorney’s authority is suspended until the Grantor again becomes incapable.

2. SCOPE OF AUTHORITY

2.1 The Grantor authorizes the Attorney to make decisions on the Grantor’s behalf regarding all aspects of personal care, including but not limited to: (a) consenting to, refusing, or withdrawing consent to any healthcare, treatment, or medical procedure; (b) admission to or discharge from any hospital, long-term care home, retirement residence, or other care facility; (c) decisions regarding the Grantor’s nutrition, including artificial nutrition and hydration; (d) decisions regarding the Grantor’s shelter, housing, and living arrangements; (e) decisions regarding the Grantor’s clothing, hygiene, and safety; and (f) retaining healthcare professionals and service providers.

2.2 Limitations on Authority. The Attorney shall have no authority to: (a) consent to Medical Assistance in Dying (MAID) under the Criminal Code of Canada on behalf of the Grantor — only the patient may make a request for MAID; (b) make financial or property decisions on the Grantor’s behalf — such authority requires a separate Power of Attorney for Property; (c) make or change the Grantor’s will; or (d) consent to any treatment that is prohibited by law.

3. HEALTHCARE WISHES AND VALUES

3.1 The Grantor expresses the following healthcare wishes and values, which the Attorney shall consider and follow when making decisions on the Grantor’s behalf:

3.2 General Healthcare Values. [General Healthcare Wishes]

3.3 Religious and Cultural Considerations. [Religious/Cultural Considerations]

4. LIFE-SUSTAINING TREATMENT

4.1 Life-Sustaining Treatment. If the Grantor is in a terminal condition with no reasonable prospect of recovery, or in a persistent vegetative state, the Grantor’s wish regarding life-sustaining treatment is as follows: [Life Sustaining Preference]

4.2 Pain Management. [Pain Management]

5. SPECIFIC TREATMENT PREFERENCES

5.1 The Grantor expresses the following specific treatment preferences: [Treatment Preferences]. These preferences are intended to guide the Attorney but do not limit the Attorney’s authority to make treatment decisions that are in the Grantor’s best interests if circumstances arise that are not addressed above.

6. PERSONAL CARE AND LIVING ARRANGEMENTS

6.1 Shelter and Housing. [Shelter Preference]

6.2 Additional Personal Care Instructions. [Additional Care Instructions]

7. DUTY TO FOLLOW WISHES

7.1 The Attorney shall, in making a decision on the Grantor’s behalf, follow any wishes the Grantor expressed while capable that are applicable to the circumstances, whether expressed in this document or otherwise. If the Grantor’s wishes are not known or are not applicable to the circumstances, the Attorney shall act in the Grantor’s best interests, taking into consideration the Grantor’s values, beliefs, and the following factors: (a) whether the Grantor’s condition is likely to improve, remain stable, or deteriorate; (b) whether the benefit of a proposed treatment outweighs the risk of harm; and (c) whether a less restrictive or less intrusive course of action is available.

8. REVOCATION

8.2 Right to Revoke. The Grantor may revoke this Power of Attorney at any time while the Grantor is capable of personal care by: (a) executing a new Power of Attorney for Personal Care; (b) providing written notice to the Attorney; or (c) any other act that clearly indicates the Grantor’s intention to revoke.

9. GENERAL PROVISIONS

9.1 Scope Limited to Personal Care. This Power of Attorney applies only to personal care decisions. The Attorney has no authority to manage the Grantor’s property or financial affairs under this document.

9.2 Liability. The Attorney shall not be liable for any decision made in good faith and in accordance with the Grantor’s wishes or, where wishes are unknown, in the Grantor’s best interests.

9.3 Severability. If any provision of this Power of Attorney is found to be invalid, illegal, or unenforceable, the remaining provisions shall continue in full force and effect.

9.4 Governing Law. This Power of Attorney shall be governed by and construed in accordance with the laws of the Province of [Province] and the applicable federal laws of Canada.

9.5 Binding Effect. This Power of Attorney shall be binding upon the Grantor, the Attorney, and all healthcare providers and institutions who receive a copy of this document in good faith.

IN WITNESS WHEREOF, the Grantor has executed this Power of Attorney for Personal Care as of the date first written above.

WITNESS ATTESTATION

We, the undersigned witnesses, each declare that we were both present and saw the Grantor sign this Power of Attorney for Personal Care. We are each at least eighteen (18) years of age and are not the Attorney, the Attorney’s spouse or partner, a minor, or a person under guardianship or who provides healthcare, residential, social, training, or support services to the Grantor for compensation.

Witness 1: [Witness 1 Name] Address: [Witness 1 Address] Signature: ___________________________

Witness 2: [Witness 2 Name] Address: [Witness 2 Address] Signature: ___________________________

Grantor

________________

Signature

Attorney for Personal Care

________________

Signature

Maintained by Vladislav Sergienko, Founder·Template last modified: ·Report an error

What Is a Power of Attorney for Personal Care (Canada)?

A Power of Attorney for Personal Care in Canada authorises a named attorney to make personal-care and medical decisions if the grantor loses capacity, governed primarily by provincial health-care consent and substitute-decision legislation.

The terminology and governing legislation vary significantly across provinces. In British Columbia, the equivalent document is a Representation Agreement under the Representation Agreement Act (R.S.B.C. 1996, c. 405) — a Section 7 agreement covers routine financial and personal care matters, while a Section 9 agreement grants broader authority including the power to give or refuse consent to healthcare necessary to preserve life. In Alberta, the equivalent is a Personal Directive under the Personal Directives Act (R.S.A. 2000, c. P-6), which appoints an Agent to make personal and medical decisions. In Manitoba, the Health Care Directives Act (C.C.S.M. c. H27) governs the appointment of a healthcare proxy.

The Power of Attorney for Personal Care is fundamentally different from a Power of Attorney for Property — the former covers healthcare, nutrition, shelter, clothing, hygiene, and safety, while the latter covers financial and property management. They are separate documents, and granting one does not grant the other. The Attorney for Personal Care has no authority over the Grantor’s bank accounts, investments, or real estate. Under Ontario’s SDA, the Grantor must be at least 16 years old to make a Power of Attorney for Personal Care (s. 46(1)), and the Attorney must be at least 18 years old and must not be someone who provides healthcare, residential, social, training, or support services to the Grantor for compensation, unless that person is also the Grantor’s spouse, partner, or relative (s. 46(3)).

The legal framework governing the Power of Attorney for Personal Care (Canada) in Canada draws on several key statutes and regulatory bodies. Under Canadian law, PIPEDA and provincial privacy legislation govern personal data processed under this agreement. The Competition Act (R.S.C. 1985, c. C-34), enforced by the Competition Bureau, protects consumer rights. Section 15 of the Canada Business Corporations Act governs corporate obligations. Provincial superior courts and the Federal Court of Canada have jurisdiction for civil matters. The Canada Revenue Agency (CRA) administers tax compliance obligations. Parties executing a Power of Attorney for Personal Care (Canada) in Canada should confirm the document reflects current law, including any amendments enacted since the original drafting date. The Provincial Succession Law Reform Acts sets the foundational requirements.

When Do You Need a Power of Attorney for Personal Care (Canada)?

A Canadian Power of Attorney for Personal Care is needed whenever an individual wants to confirm that a trusted person will be authorized to make healthcare and personal care decisions on their behalf if they become mentally incapable. Without this document, healthcare providers must rely on the statutory hierarchy of substitute decision-makers under the Health Care Consent Act (Ontario) — which may not result in the person the Grantor would have chosen, and which can lead to family disputes and delays in care.

The Canada Power of Attorney for Personal Care (Canada) document is essential for older Canadians planning for cognitive decline, including Alzheimer’s disease, dementia, and other conditions that progressively impair decision-making ability. It is equally critical for younger adults who may be rendered incapable by accident, stroke, or sudden illness. The document should be executed while the Grantor is capable — once incapacity occurs, it is too late.

The Power of Attorney for Personal Care is particularly important when the Grantor has strong preferences about end-of-life care, life-sustaining treatment, or religious and cultural values that should govern healthcare decisions. While an advance directive states the Grantor’s wishes, it does not appoint a decision-maker — the Power of Attorney for Personal Care does both: it appoints a decision-maker and provides guidance about the Grantor’s wishes.

Families with complex dynamics — blended families, estranged relatives, or family members who disagree about healthcare values — benefit from a clear Power of Attorney for Personal Care that designates a single decision-maker and provides specific instructions, reducing the potential for conflict and confirming that the Grantor’s wishes are followed rather than those of the most vocal family member.

Canadians with chronic health conditions, those planning for elective surgery, and those who travel frequently should also have this document in place as part of a thorough personal planning strategy alongside a will and a Power of Attorney for Property.

What to Include in Your Power of Attorney for Personal Care (Canada)

A valid Canadian Power of Attorney for Personal Care must clearly identify the Grantor with their full legal name, date of birth, and address. The Attorney for Personal Care must be named with sufficient identifying information, including their relationship to the Grantor and contact information so that healthcare providers can reach them in an emergency. An alternate Attorney should be named in case the primary Attorney is unable, unwilling, or becomes ineligible to act.

The document should express the Grantor’s healthcare wishes and values in as much detail as possible. Under Ontario’s SDA s. 66(4), the Attorney must follow any applicable wishes the Grantor expressed while capable — so the more guidance provided, the more likely the Grantor’s preferences will be honoured. Key areas to address include: life-sustaining treatment preferences (ventilation, CPR, dialysis, artificial nutrition), pain management priorities, specific treatment consents or refusals (blood transfusions, surgery, organ donation), religious or cultural values that should guide decisions, and preferences about shelter and housing (remaining at home vs. long-term care).

Witness requirements are mandatory and vary by province. In Ontario, two witnesses are required, and neither may be the Attorney, the Attorney’s spouse or partner, a minor, or a person under guardianship. Under s. 46(3), a person who provides healthcare or residential services to the Grantor for compensation cannot serve as the Attorney unless they are the Grantor’s spouse, partner, or relative. In BC, a Section 9 Representation Agreement requires two witnesses. In Alberta, a Personal Directive requires at least one witness.

The document must clearly state that the Attorney’s authority is limited to personal care decisions and does not extend to financial or property matters. It should note that the Attorney cannot consent to Medical Assistance in Dying (MAID) under the Criminal Code — only the patient may request MAID. The governing law clause must reference the specific Canadian province whose healthcare legislation applies.

Additional compliance elements for a Power of Attorney for Personal Care (Canada) used in Canada include: Under Canadian law, PIPEDA and provincial privacy legislation govern personal data processed under this agreement. The Competition Act (R.S.C. 1985, c. C-34), enforced by the Competition Bureau, protects consumer rights. Section 15 of the Canada Business Corporations Act governs corporate obligations. Provincial superior courts and the Federal Court of Canada have jurisdiction for civil matters. The Canada Revenue Agency (CRA) administers tax compliance obligations. Forms-legal.com provides this template as a starting point for Canada-compliant documentation.

Sources & Citations

Statutory citations link to official government sources.

  1. R.S.C. 1985, c. C-34CA official

Cite this page

Reference this free template in an article, syllabus, or research note:

APA

Forms Legal. (2026). Power of Attorney for Personal Care (Canada) (Canada) [Legal document template]. Forms Legal. https://forms-legal.com/canada/estate-planning/power-of-attorney/power-of-attorney-personal-care-canada

MLA

"Power of Attorney for Personal Care (Canada) (Canada)." Forms Legal, 2026, https://forms-legal.com/canada/estate-planning/power-of-attorney/power-of-attorney-personal-care-canada.

BibTeX
@misc{formslegal-power-of-attorney-personal-care-canada,
  author       = {{Forms Legal}},
  title        = {Power of Attorney for Personal Care (Canada) (Canada)},
  year         = {2026},
  howpublished = {\url{https://forms-legal.com/canada/estate-planning/power-of-attorney/power-of-attorney-personal-care-canada}},
  note         = {Free legal document template. Based on Provincial Powers of Attorney / Substitute Decisions legislation (Ontario: Substitute Decisions Act, 1992)}
}

Also available for these jurisdictions:

Frequently Asked Questions

Based on Provincial Powers of Attorney / Substitute Decisions legislation (Ontario: Substitute Decisions Act, 1992) — Template last modified June 2026

This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer

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