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White Coat Black Art

Life can change overnight. 2 families share what people should know about power of attorney

A woman who is acting as power of attorney for her previously healthy brother following a massive stroke says there should be more resources available to help Canadians prepare to take over for a loved one when just in case becomes a reality.

Mary Jarratt was thrown into action as power of attorney when her brother had a life-changing stroke

A woman sits beside a man lying on a hospital bed -- both looking at the camera.
When Dr. Mary Jarratt's brother, Billy Jarratt, left, had a debilitating stroke at 58, she was thrown into the role of power of attorney. She had to make tough decisions about his care, the care of his teenaged son and whether to sell the family home. (Brian Goldman/CBC)
When Mary Jarratt's brother, Billy, had a debilitating stroke at the age of 58, she was thrown into the role of power of attorney. That meant making significant decisions on Billy's behalf, including his personal care, the care of his high school-aged son, and whether to sell the family home. It has taken a physical and emotional toll on her and she wants people to know what theyre getting into when they sign up to be a POA.

Originally published on Jan. 22, 2024.

When Dr. Mary Jarratt's brother, Billy Jarratt, asked in 2018 if he could designate her as power of attorney in the event something should happen to him, she thought little of it.

Billy's wife had just died, so while updating his will, he also needed to designate someone new to make medical and financial decisions for him should he no longer be able to do so himself.

"Billy was the last person that you'd ever would have thought would become disabled," Mary told Dr. Brian Goldman, host of CBC Radio's White Coat, Black Art.

"Billy led a very active life. He had a very good job. He'd been with the senior management of the town of Oromocto [N.B.] for 32 years worked out at the gym every day."

But in January 2023, at the age of 58,he had a massive hemispheric stroke that left him unable to speak and reliant on a wheelchair.

Mary is a family physician from Saint John and therefore familiar with power of attorneysituations but she says she still underestimated what's involved. Now she's calling for more awareness of the topic and easier access to resources for Canadians to help them make informed decisions about power of attorney, and to help them prepare to take over if needed.

A woman shows holds a picture frame showing several photos.
Mary shows a picture frame with photos of her brother from before his stroke. (Brian Goldman/CBC)

The laws that govern power of attorney (POA) vary depending on your province or territory, as does some of the terminology. In New Brunswick, where the Jarratts live, the process is guided by the Enduring Powers of Attorney Act that came into effect in 2020.

You might assign a power of attorney for a short period when you need someone to take care of a financial matter while you're out of the province. An enduring power of attorney, on the other hand,is what's required for an ongoing situation such as Billy's.

There are two types of enduring powers of attorneyan attorney for personal care, who makes decisions on your health care, and an attorney for property, for financial matters. These duties can be assigned separately. If it's the same person, however, it can be taken care of with one form in New Brunswick.

Mary Jarratt said that when it became clear that Billy was going to survive his stroke, it was time for her to start to try to take charge.

"Billy owns a house, he has a son in school, two [adult] stepchildren that were living with him at the time," she said."Lots of bills and various responsibilities."

The search for documents

Their biggest mistake, according to Mary? Billy had not given his sister a copy of his will and power of attorney. Without those documents, she couldn't proceed with the crucial work she needed to do. His lawyer had retired and had not kept copies of his client's files.

Initially they found a copy, said Mary, but for privacy and fraud-prevention reasons, the bank needed originals in order for her to access his accounts.

Once those were found, the next major hurdle was the utility bills. "The challenge with that today is that everything's electronic," she said.

Billy didn't have atrusty shoe box or accordion folder with everything she'd need. He had been the only one with the account numbers, let alone the passcodes. She had to slowly approach each organization and figure out how to get access.

A man in a hospital-type bed looks up at a woman who is leaning over the edge of his bed.
Billy looks at his sister during a visit at the assisted living facility where he's lived since leaving the hospital his stroke in January 2023. (Brian Goldman/CBC)

But that's only the money side of the equation. Mary also had to ensure there was a plan for taking care of her nephew, Billy's son, Shane, who still had a year of high school to complete (one of the hockey moms in Shane's life took him in so he could do Grade 12 with his friends), find a live-in care facility for Billy and eventually make the difficult decision to sell his house.

Lawyer Kavina Nagrani, who specializes in estate and elder law in Ontario, said she recommends that the person designated by the POA documentsat least know the location of a dossier of documents containing the pertinent information in the event something happens.

'Duties are endless'

Michelle McDonald, chief executive officer of the non-profit Brain Injury Canada, said a POA's "duties are endless" and often come on top ofhands-on caregiving.

"I don't think people understand the magnitude of this," said McDonald. She noted that in most cases that's fine because the worst never comes to pass.

But in her organization's work with those affected by brain injuries, she's seen some complex situations that people acting as attorneymust navigate. "And there really is no training," said McDonald.

When you Google the topic, the top results are mostly from law firms, so it's hard to get unbiased information, she said.

"Because the impairments that are associated with brain injury can be cognitive, physical, emotional, behavioural, that can make it a challenge in itself for someone who's a power of attorney," she said.

"That person themselves might not know that they need someone, or they may be resistant to having someone else making decisions for them."

She says more could be done to support family caregivers thrust into the role of attorney by creating resources and training.

When we were younger it was all theoretical and abstract. This time it was real.- Mike Cels

When Mike Cels of Oakville, Ont., was first diagnosed at age 54 with amyotrophic lateral sclerosis (ALS), a degenerative motor neuron disease, back in 2017, both he and his wife, Carmen Cels, had a lot to get their heads around. Fortunately, they weren't new to the concept of a power of attorney.

Married in 1996, they'd drawn up wills once they had children a few years later, said Mike. The next time those needed an update but while they were both still healthy they designated each other as power of attorney.

A man in an electric wheelchair smiles widely while posing in front of an ancient building while travelling.
Mike Cels, who is living with ALS, travelled to Petra, Jordan, with his wife, Carmen Cels, in early 2020, their last international trip before the pandemic stopped all travel. Petra was a bucket-list destination for Mike. (Submitted by Carmen Cels)

Speaking to CBC through assistive technology that allows him to use his eyes to type out responses to questions, Mike said that when his disease had progressed considerably by 2020, he and Carmen "realized that we had to update everything to ensure it reflected our new reality."

"When we were younger, it was all theoretical and abstract," he said. "This time it was real."

Today, the couple's power of attorney documents account for every scenario, including each of them needingalternate attorneysshould something else unexpected happen.

Carmen said she maintains a portfolio of documents that includes their wills, POAs, financial details, cemetery plots and contact numbers for their lawyer and financial planner. One copy lives in a safe deposit box and another in an encrypted computer file their children, now in their 20s, know how to access.

A man in an electric wheelchair is flanked by two young adult children and his wife on a lawn with trees in the background.
Mike, pictured here in his wheelchair with, from left, his son, Jonathan, wife, Carmen and daughter, Cynthia, at a wedding in Winnipeg in September 2023, was diagnosed with ALS in 2017. He said it helped that they had already set up powers of attorney. (Submitted by Carmen Cels)

As things stand today, says Carmen, Mike still makes decisions on his health care. "As I advocate for his care today, I can identify options and potential care plans, and I can suggest reasonable next steps. And yet, sometimes he selects a route that I wouldn't have expected or chosen for him.

"And so sometimes I wonder if I can make the decision that Mike would want when the time comes and he can't direct me."

Crucial conversations

It takes a lot of open conversation about the kind of scenarios they may face with the progression of a disease, said Mike.

That's a kind of conversation people don't get to have when their situation changes drastically overnight, as Billy Jarratt's did.

Looking back, Mary said she regrets not talking to her brother sooner about what his wishes would be. She wants others to avoid the same pain.

"If someone asks you to be POA, spend an hour sitting down with them just getting an idea of what their wishes would be and maybe some basics about their finances, about their house and what they would want for their children."

Produced by Colleen Ross

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