Planning for a time when you cannot make your own health care decisions is one of the most thoughtful acts you can do for yourself and your family. A personal directive is a legal document under Nova Scotia's Personal Directives Act that allows you to document your wishes about future personal care services or decisions, and to appoint someone to make these important decisions if you become unable to communicate or decide for yourself.
This guide explains what personal directives are for Nova Scotians, how to make a personal directive properly, what health care decisions you can address, and how to avoid common mistakes that could invalidate your wishes.
- What is a Personal Directive in Nova Scotia
- Legal Requirements and Capacity Rules
- Types of Decisions You Can Authorize in a Personal Directive
- How to Create and Execute Your Personal Directive
- Selecting and Instructing Your Delegate
- Personal Directive Storage Options
- Updating and Revoking Your Personal Directive
- Consequences of Not Having a Personal Directive
- Common Personal Directive Mistakes to Avoid
- How Personal Directives Work with Other Legal Documents
- Getting Professional Help with Your Personal Directive
- FAQs About Personal Directives in Nova Scotia
What is a Personal Directive in Nova Scotia
A personal care directive is a legal document under Nova Scotia's Personal Directives Act that allows you to document your wishes about future personal care decisions and appoint someone to make those decisions if you become unable to communicate or make decisions yourself. This document addresses medical treatment options, living arrangements, home care services, community services, and other personal care decisions or different matters—but it does not cover financial or property decisions, which require a separate power of attorney. The purpose of a personal directive is to ensure your voice guides your personal care decisions even when you cannot speak for yourself.
Without this document, other people may have to guess what you would have wanted, which can lead to difficult situations during an already stressful time. Your family experiences less conflict because your wishes are documented clearly, reducing disagreements about what personal care decisions you want. Health care providers and hospital staff also benefit from having explicit guidance, which helps them deliver personal care that respect your preferences rather than making assumptions.
Legal Requirements and Capacity Rules
Personal directives in Nova Scotia are governed by the Personal Directives Act, provincial legislation that gives these documents legal authority. The Act outlines who can create a directive, what decisions it can address, how it gets executed, and when it takes effect.
To make a personal directive, you have to be at least 19 years old and have the mental capacity to understand what you're doing. Capacity means you comprehend the nature and consequences of the directive; specifically, that you understand what decisions the document addresses, who you're appointing to make decisions, and that your delegate will have authority to act on your behalf. If questions arise about your capacity at the time you created the directive, a formal capacity assessment by a qualified professional may be conducted to determine whether the document is valid.
Your personal directive only becomes active when you lose the capacity to make decisions for yourself. Health care providers determine incapacity based on clinical assessments and professional judgment about your ability to understand information, appreciate consequences, and communicate decisions.
Types of Decisions You Can Authorize in a Personal Directive
Health care treatment decisions form the core of most personal directives. You can provide instructions about medical procedures, medications, surgery, diagnostic tests, and life-sustaining treatments like ventilators or dialysis. Your directive might specify treatment options you want to receive, treatments you want to refuse, or conditions under which certain interventions get used or not used.
You can also address accommodation and living arrangements in your directive. This includes stating where you wish to live if you can no longer care for yourself independently—whether at home with support services (such as a home care services provider), in an assisted living facility, or in a continuing care home (long-term care). Your directive might include instructions for preferred facilities, express preferences about living with family members, or outline the level of independence you want maintained as long as possible.
Nutrition and personal comfort measures represent another important category of decisions:
Nutrition preferences and dietary restrictions
Whether you would want a feeding tube if you could not eat on your own
Pain management approaches
Clothing hygiene safety comfort
Social activities and recreation
Religious or cultural practices that influence your personal care
End-of-life care instructions allow you to express your wishes about your personal care during your final days or weeks. You can provide guidance on palliative care approaches, do-not-resuscitate (DNR) orders, organ donation, and whether you want to be hospitalized or remain at home. Clear, specific language in this section helps your health care providers and family understand exactly what you want during this sensitive time.
How to Create and Execute Your Personal Directive
Creating a personal directive starts with gathering relevant information about yourself. This might include collecting details about your medical history as well as any current health conditions, medications, allergies, not to mention any religious or cultural beliefs that influence your personal care decisions and preferences.
You might consider custom drafting if you have complex medical needs, intricate family dynamics, specific religious requirements, or want to integrate your directive with broader estate planning documents.
Proper execution requires one witness who is present when you sign your directive. Your witness cannot be your appointed delegate, and your witness generally cannot be a beneficiary under your will or someone who provides you with health care services. The witness signs the document confirming they watched you sign, that you appeared to have capacity, and that you signed voluntarily without pressure from others.
Selecting and Instructing Your Delegate
Your delegate has to be at least 19 years old, mentally capable of making decisions, and willing to accept the responsibility. Your delegate generally cannot be your health care provider or an employee of a facility where you receive personal care, though limited exceptions exist under specific circumstances outlined in the regulations.
Once appointed, your delegate has clear legal duties. This individual follows your stated wishes as expressed in your directive and, using their decision making authority, acts in your best interests when your directive does not address a particular situation. The law provides delegates with immunity for good-faith decisions made according to your directive, protecting them from liability when they genuinely attempt to honour your wishes.
Providing clear written guidance makes your delegate's job easier during what will likely be a stressful time. Compare these two examples:
Clear instruction: "If I have advanced dementia and cannot recognize nearest relatives, I do not want CPR or intubation."
Vague instruction: "Do what's best for me."
The first example gives your delegate specific direction, while the second leaves them guessing. Discuss likely scenarios with your delegate in advance so they understand not just what you want, but why—this context helps them make decisions about situations you may not have explicitly addressed.
Personal Directive Storage Options
Provide copies directly to your family doctor, any specialists you see regularly, and your local hospital. Keep the original in a safe but accessible location—not a safety deposit box, which may be difficult to access quickly. Your delegate and key family members need to know exactly where the original and copies are stored so they can retrieve them when needed.
Consider modern access methods for emergencies:
Store a digital copy in secure cloud storage that trusted people can access
Wear a medical alert bracelet indicating you have a personal directive
Carry a wallet card with information about where your directive can be found
Updating and Revoking Your Personal Directive
You can change or cancel your personal directive at any time, but you have to have mental capacity to do so. Capacity is required because modifying a directive is essentially the same as creating a new one—you have to understand what you're changing and why. No one else, including your delegate or family members, can modify your directive on your behalf.
To formally revoke an existing directive, provide written notice to everyone who has a copy, destroy all copies you control, and follow any specific revocation procedures mentioned in your document. Keep a written record of the revocation with the date and your signature. If you're replacing an old directive with a new one, the new document typically includes language explicitly revoking all previous directives.
Notify all relevant parties promptly about any updates or revocations. This includes your health care providers, your delegate, alternate delegates, and family members who might be involved in your care.
Consequences of Not Having a Personal Directive
Without a personal directive, Nova Scotia law establishes a substitute decision-maker hierarchy to determine who makes decisions for you. The law typically looks to your spouse or domestic partner first, then your adult children, then your parents, then your adult siblings, and finally other adult relatives.
This hierarchy can create delays if the appropriate person is difficult to locate, and it can lead to serious conflicts if family members at the same level disagree about your care. When no eligible substitute decision-maker exists, or family members cannot agree, someone may need to apply to court for adult guardianship. Doing so often involves legal applications, court hearings, assessing capacity, and potentially significant legal fees.
A statutory decision maker may be appointed by law if you do not have a personal health care directive in place.
Common Personal Directive Mistakes to Avoid
Unclear or contradictory language creates confusion when your directive is needed most. Avoid vague terms like "extraordinary measures" or "reasonable treatment" without defining what you mean. Instead, use specific, concrete descriptions of situations and your wishes for each.
Improper witnessing and execution errors can invalidate your entire directive:
Forgetting to sign the document
Using a witness who is ineligible under the law
Failing to complete all required sections of the form
Many people create a personal directive but never discuss it with their chosen delegate named. Your delegate might not even know they've been appointed, or they might be unwilling to serve but never had the chance to say so. Schedule a conversation to review your wishes, confirm your delegate accepts the role, and check in periodically to keep them updated.
How Personal Directives Work with Other Legal Documents
Personal directives, powers of attorney, and wills serve different purposes and operate at different times. For instance, your personal directive does not give anyone authority over your finances—that requires a power of attorney. Neither document distributes your property after death—that's the role of your will.
You may encounter terms like "advance directive," "advance care plan," or "living will" when researching personal directives. In Nova Scotia, the terms are sometimes used interchangeably with "personal directive," though they may have specific meanings in other provinces or countries. When creating your personal directive, it's important to focus on creating one that meets Nova Scotia's legal requirements under the Personal Directives Act.
Getting Professional Help with Your Personal Directive
When it comes to making a personal directive, certain situations benefit from professional legal guidance. Consider consulting an estate planning lawyer if you have complex medical conditions requiring detailed instructions, if you anticipate potential family conflicts over your care, if you own business interests that might be affected by health care decisions, or if you want your directive integrated into a comprehensive estate plan.
LM Legal Solutions offers estate planning services with a personalized, client-focused approach. Our team takes time to understand your health situation, family dynamics, values, and goals to ensure your personal directive truly reflects your wishes. Book a consultation to discuss your personal directive and broader estate planning needs.
FAQs About Personal Directives in Nova Scotia
Is a personal directive made in another province valid in Nova Scotia?
Generally yes, if the directive was properly executed according to that province's legal requirements at the time it was created. However, Nova Scotia health care providers are most familiar with local forms and the specific requirements of the Personal Directives Act, so you might consider updating to a Nova Scotia format after relocating.
Can I appoint multiple delegates for my personal directive?
Yes, you can appoint alternate delegates who step in if your first choice is unavailable, unwilling, or unable to serve. Only one delegate acts at a time.
Does getting married automatically revoke my existing personal directive?
No, marriage does not automatically cancel a personal directive in Nova Scotia the way it revokes a will. Your personal directive remains valid after marriage. However, you might want to review and update your directive after major life changes like marriage, divorce, or the death of your appointed delegate.
