If you do not have a designated Primary Caregiver in cases of emergency, the healthcare provider such as hospitals, care homes doctors and nurses are required to select someone who meets the qualifications of a Temporary Substitute Decision Maker in this order:

  1. Your spouse – includes same sex and common law marriage-like relationships. There is no minimum time you must have lived together.
  2. If there is no spouse who qualifies, the provider will continue down the list to find one of the following who is related to you by birth or adoption:
    • An adult child;
    • A parent;
    • A sibling;
    • A grandparent;
    • A grandchild;
    • Other relative
  1. If no one related by birth or adoption is available or qualified, the provider will look for:
    • A close friend (defined as an adult who has a long-term, close personal relationship involving frequent personal contact with you, but who does not
      receive compensation for providing personal care or health care to you);
    • A person who is immediately related by marriage (for example, an in-law)

Albert has three adult children who could be selected to be his TSDM – Patrick, Ashley or Paul. If Albert did not name a representative)s) in a Representation Agreement, the doctor could select Patrick as TSDM to give or refuse consent for the medication and tests right now. Because the authority of a TSDM is “temporary,” the doctor might select Ashley as TSDM at another time. See Nidus Personal Planning Resource Centre for more information.

Any of these people above may be exactly whom you would want, but consider if they live near you, are they capable or do they want to take on this role. You should also consider someone who understands your wishes, values and even knows personal habits. This person will give the healthcare provider guidance with medical wishes and help provide the daily staff with information about you to help ensure your quality of life.

6. Why should we have a primary caregiver?

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