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My Personal Directive

A personal directive is one of the greatest gifts you can give yourself and those who care about you. You must make your personal directive while you can still make decisions for yourself. You might not be able to make health care decisions for yourself at some time in the future. A personal directive can help to make sure that you get the care you want. It can help the people who care about you by letting them know what kinds of care you want.

The people who will most likely make your health care decisions when you cannot are the people who care about you. A personal directive gives them the comfort of knowing what you wanted. It can take the responsibility for making important decisions for you off their shoulders – they will not have to try to guess what you would want.

A personal care directive may also mean fewer disagreements between the people who care about you and the people who provide your healthcare.

You can use your personal directive to do any or all of the following:

  • You can name someone to make personal care decisions for you. This person is called your delegate. You don’t need to do more than that, but you can.
  • You can say what personal care decisions you want to be carried out and how you want them to be carried out.
  • You can describe your values and beliefs to help guide those who will make personal care decisions for you as well as the people who will carry out those decisions.

Personal directives are for personal care (including health care) decisions only. They do not tell others how to make decisions about financial and property matters. For these decisions, you must use other legal documents, like an enduring power of attorney or a will. You can learn more about these from the Legal Information Society of Nova Scotia at https://www.legalinfo.org/wills.

Three definitions might help you make your personal directive:

  • “Personal care” includes health care, nutrition, hydration (fluids), where you live, clothing, hygiene, safety, comfort, recreation, social activities, support services. It can also include other things. It can include decisions about whether you live in a continuing-care home or at home with home-care services.
  • “Health care” means any examination (test), procedure, service, or treatment that is done for a health-related purpose. It includes a course of health care or a care plan.
  • “Health care decision” includes instructions you give, for example, consenting to or refusing care or treatment, or withdrawing your consent to health care.

Your personal directive comes into effect only when you cannot make personal care decisions. That is called “losing capacity.”

You have capacity when you can

  • understand information you need to make a personal care decision and
  • appreciate what could happen if you make or do not make a decision.

Your personal directive is no longer in effect when you

  • regain capacity or
  • die or
  • cancel the personal directive

or when a court decides it is no longer in effect.

We recommend that you complete the “Nova Scotia Personal Directives Workbook” before going through this app. The workbook will help you to make the decisions that you will talk about in your personal directive. If you have filled out the workbook or feel ready to make your personal directive, please go ahead.

The star (*) shows where you must give an answer.

To continue with this app, you must click yes
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Naming someone to make decisions for you—your delegate

You may use your personal directive to name someone to make personal care decisions for you when you cannot do it yourself. That person is called a delegate. Your delegate does not have to be a relative. They must be at least 19 years old, unless they are your spouse. Your spouse can be your delegate even if they are under 19.

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More than one delegate named

In most cases, it is best to name only one delegate. However, the law allows you to name more than one person to act as delegates for you. If you name more than one person, you must clearly give each delegate authority for different matters. This makes sure that only one person can make decisions in any area and avoids conflicts between decision makers.

No delegate named

You can choose not to name a delegate to make personal care decisions for you. Even if you do not choose a delegate, you can leave instructions and wishes about your personal care. These options come up later in the app.

If you do not name a delegate and do not leave instructions or wishes that are clear and related to a decision that must be made, your care providers will turn to a “statutory decision maker” to make certain personal care decisions for you. A “statutory decision maker” is someone who is given the power by law (rather than your personal directive) to make decisions for you about your care. For example, they could accept an offer to place you in a continuing-care home or to receive home-care services. The law lists the people who will be asked to serve as a statutory decision maker. This list includes your relatives and the Public Trustee if no relative can make the decision. If you have relatives you do not want to have the power to make these decisions for you, be sure to fill out the section Excluding Decision Makers.

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You may also name an alternate delegate who can make decisions about your personal care if your delegate cannot, will not, or is not available. You may also name more alternate delegates to make decisions in case your first alternate cannot. An alternate delegate must be 19 unless they are your spouse.
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Giving delegates power to choose a replacement delegate

You may allow your delegates to give their responsibilities for your personal care decisions to someone else. This is called sub-delegating their authority to another person. That person will have all the authority your delegates give them. Your delegates may sub-delegate only if you say in your personal directive that they may do so.

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Allowing a former spouse to be a delegate after divorce

If you name your spouse to act as a delegate or alternate delegate and then they stop being your spouse, your former spouse may still act as your delegate only if you say so in your personal directive. Otherwise, since your former spouse is no longer your spouse, that part of your personal directive is no longer valid.

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Excluding decision makers

Even if you do not choose delegates or leave personal care instructions or wishes, someone still might need to make a personal care decision for you.

In that case, health care workers must find someone who can be named as your delegate. Nova Scotia law says who can be asked. The people on the list are your relatives and the Public Trustee. They are called “statutory decision makers.” If you have a relative you do not want to make decisions for you, you should say that in your personal directive.

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Instructions and wishes about personal care

You may give instructions or make statements about your wishes for personal care. If you do, your delegates (if you have any), or statutory decision makers, or your health care providers must follow them.

You can choose to not leave any instructions or wishes about your personal care decisions. If you do this, anyone who makes personal care decisions for you must base them on what they know about your values and beliefs.If they do not know you well, they must decide based on what they think would be in your best interests.

Talk to your health care providers about these instructions so they can give you good information about health conditions and treatment options.

You maysay in your personal directive what instructions or wishes about personal care you want to be followed. Three definitions to remember are:

  • “Personal care” includes health care, nutrition, hydration (fluids), where you live, clothing, hygiene, safety, comfort, recreation, social activities, support services. It can also include other things. It can include decisions about whether you live in a continuing-care home or at home with home care services. 
  • “Health care” means any examination (test), procedure, service, or treatment that is done for a health-related purpose. It includes a course of health care or a care plan. 
  • “Health care decision” includes instructions you give, for example, consenting to or refusing care or treatment, or withdrawing your consent to health care.

In your personal directive, you may instruct your delegate to refuse any kind of health care(for example, CPR, antibiotics, blood transfusions, artificial hydration and nutrition, and nutrition and liquids to drink). Health care providers must respect these wishes.

You may include an instruction to ask for any kind of personal care, but requests cannot always be followed.For example, the hospital might not have a technology you want to be used, or a nursing home you like might not have a bed for you. However, if you add these instructions, your wishes are more likely to be followed.

Be as clear as possible in your instructions or wishes. Say what kinds of care you do or do not want and when. For example:

“I do not want blood transfusions under any circumstances.”  
“I want to be given a vegetarian diet at all times.”
“I want to live at home as long as I can afford to do so.”

Medical assistance in dying and organ donation

Your family and doctors cannot legally follow an instruction to give you medical assistance in dying (MAiD).

Health care providers cannot legally follow an instruction to take some or all of your organs or tissues for living organ donation.
Some health care practices can make your organs more useful for transplantation after your death. You can leave instructions in your personal directive that you want these kinds of care while you are still alive.

To donate your organs after your death, you must sign the organ donor form when you register or renew your health card.

The Nova Scotia Personal Directive Workbook has helpful information for this step.
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Values and beliefs relevant to personal care

If you do not give clear instructions or a clear description of your wishes above, your delegate will have to make decisions about your care based on what they think you would want based on what they know about your values and beliefs. If you don’t name a delegate or leave clear instructions or wishes about your care, a statutory decision maker must act according to what they think you would want.

You can choose to not write down your values and beliefs about your personal care decisions. But in this case, your delegate or statutory decision maker will have to make personal care decisions for you based on what they know of your values and beliefs. If they do not know what your values and beliefs are, they would have to decide based upon what they believe would be in your best interests.

In your personal directive, you can tell your delegates and health care providers about things like:

  • your beliefs about the value of life and the meaning of suffering
  • religious or spiritual rites, rituals, and care you want performed before you die
  • your cultural or moral commitment to a certain diet
  • the value you place on being able to move, to communicate, and to read
  • the value you place on being able to see or go into nature
  • health situations you would not find acceptable
The Nova Scotia Personal Directive Workbook has helpful information for this step.
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Who the delegate must talk to when making personal care decisions

You can say in your personal directive that your delegate must talk with other people when making personal care decisions for you. You can do this by naming the people your delegate should talk with.

Instructing your delegate to talk with other people when making care decisions for you can help in two ways.

First, people who knew you when you could make decisions may know about your instructions, values, beliefs, and wishes.

Second, family members who have not been named as delegates may take comfort in being asked about personal care decisions.

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Consultation when assessing capacity

Your personal directive takes effect when you can no longer make personal care decisions for yourself. This is called losing capacity. To decide if you have lost capacity, a health care professional will assess (or test) your ability to make decisions. This might include talking with people who know you well.

You may name who you want the health care provider to talk to when they assess your capacity.

The person or people you name may be able to give information that helps the person who is assessing your capacity. It also helps the people who care about you to feel included in your care.

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Telling people about your loss of capacity

You may give instructions about who must be told when you lose capacity to make personal care decisions.You can also say who must not be told.

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The questions on this page are about paying and reimbursing delegates. As you have not chosen a delegate to make decisions for you, please just click Next.

Paying delegates to care for you

You might name someone who is not your spouse or relative to be your delegate. If you do and you wish to pay them for their services, you must say this in your personal directive.

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Paying delegates to make decisions

If you want to pay your delegates for making decisions under your personal directive, you must say that they can be paid.

Nova Scotia law says that delegates cannot be paid to make decisions under your personal directive, unless you say in your personal directive that you want to pay them.

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Repaying your delegates’ costs

If you want your delegate to be repaid for any costs they must pay while acting as your delegate, you must say that.

Even if you do not say so in your personal directive, your delegates can be repaid for reasonable costs while acting as your delegates. However, the law is not completely clear. To be sure that your delegates can be repaid for their costs, you should fill out this section.

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Review and Finalize

Review the personal directive below the submit button. You can change any of your answers by using the Prev/Next buttons. If you are finished making your personal directive, click Submit to create a page you can sign.

After you click Submit, a page will appear with a link so you can download a pdf of your responses with a signing page. If you give your email address below, we will ALSO email a copy of the pdf.

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My Personal Directive

I, , make this personal directive.

Delegate Authorization

Instructions and wishes about personal care