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REPORT OF THE DIRECTOR GENERAL: A GUIDE
PREFACE
For the last several years, the Public Curator of Quebec (PCQ) has been thoroughly reworking and
systematizing its activities for protecting the incapable persons it serves. Given that its mission is to ensure the
protection of incapable citizens with measures adapted to their condition and situation, the Public Curator
attempts to ensure that every decision with regard to their person or property is made in their interest, with
respect for their rights and to protect their autonomy.
Clients of the Public Curator are generally defined by the medical criteria for incapacity. Those deemed
incapable are often living in complex situations related to the psychosocial consequences of their incapacity, so
that special actions and expertise are required.
Accordingly, it is the report of the director general of an institution that informs the Public Curator of the state of a
person incapable of taking care of himself or administering his own affairs and needing assistance or
representation in the exercise of his civil rights. This report is completed by health and social service providers
and satisfies the requirements of the Civil Code of Quebec stipulated in article 2701.
The purpose of this section of the director general’s report is to facilitate the documentation of assessments,
cooperation among the health and social services network professionals and the routing of the reports, in order
to have medical assessments whose results are consistent with the documented psychosocial effects and
improve the assessments of the necessity for protection.
This thorough revision of the director general’s report with respect to instituting protective supervision is the
result of the work of the CPQ-MSSS task force and various consultations conducted by the Department of Health
and Social Services and the Public Curator, in order to assist healthcare providers in describing the results of
their assessments and carrying out the cooperative efforts required for a meaningful report.
INTRODUCTION
The Report of the Director General includes the Recommendations of the Director General and the Medical and
Psychosocial assessment – medical and psychosocial reports completed by the director general of the institution
or its designated director of professional services and the medical and psychosocial evaluators designated by
the director general or the director of professional services. It enables the director general of the institution to
satisfy the obligation to complete the report in the circumstances set out in article 270 of the Civil Code of
Quebec.
Upon receipt of the general director’s report, the Public Curator of Quebec makes sure that it has the information
necessary to satisfy its obligations, as set out in section 14 of the Public Curator Act. It assesses the request to
institute protective supervision adapted to the person’s situation in accordance with incapacity and need for
protection. Where appropriate, it will file a motion to institute protective supervision in court, where the form of
protective supervision recommended – curator to property and person, tutor to property or person or adviser to a
person of full age – will be determined.
Note : In this guide, “he”, “him” and “his” mean either sex.
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This section does not apply when the request to institute protective supervision has been made by the family or friends of the person concerned.
However, the persons they ask to assess incapacity and need for protection may use the Medical and Psychosocial Assessment– Medical Report and
Medical and psychosocial assessment–Psychosocial Report.
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THE MEDICAL AND PSYCHOSOCIAL ASSESSMENT – PSYCHOSOCIAL REPORT
The Medical and psychosocial assessment - psychosocial report is the last of the three parts of the Report of the
Director General, which also includes the Recommendation of the Director General and the Medical and
psychosocial assessment - medical report. Its purpose is generally to report the results of the psychosocial
assessment of the person concerned in terms of need for protection and incapacity. It is based on article 270 of
the Civil Code of Quebec (C.C.Q).
It is highly recommended that the psychosocial evaluator discuss the results of the psychosocial assessment
with the medical evaluator in order to produce consistent and corroborative assessments of incapacity and the
need for protection that contain the information required by the Public Curator, in accordance with the meaning
of article 270, C.C.Q.
You may attach additional expert opinions to this report, on condition that they are prepared at the same time.
Distribution
Print four copies of the completed Medical and Psychosocial Assessment - psychosocial report (pages 3A, 3B,
3C, 3D).
Check the addressee of each copy on the bottom of the page.
After signing, send the four copies to the Director General of the requesting institution.
1. General Information
Status Indian: a person recorded as an Indian in the Indian Register in accordance with the Indian Act.
Please note that Inuit do not live on reservations and the Indian Act does not apply to them.
Ethnic origin: ethnic origin, as defined by the census, refers to the ethnic or cultural groups to which an
individual’s ancestors belonged. This means the person’s ancestral roots or origins and should therefore not
be confused with place of birth, citizenship or nationality (Statistics Canada Daily, February 17, 1998).
Ethnic origin - examples: Arab, Armenian, Scottish, Greek, North American Indian, Inuit, Jewish, Khmer,
Kurd, Kosovar, Maya, Pashto.
Religion - examples: Roman Catholic, Protestant, Christian Orthodox, Muslim, Jewish, Buddhist, Hindu,
Sikh.
2. Residence
Domicile: place where a person resides, in other words, a private home or self-contained domestic
establishment, which includes private houses, apartments, studios, rooming house and subsidized2.
No permanent address: a homeless person.
C.H.S.L.D.: Centre d’hébergement et de soins de longue durée (long-term care nursing home). Can be
public or private.
C.H.: Centre hospitalier. (hospital)
C.H.S.G.S.: Centre hospitalier de soins généraux et spécialisés (General and special care hospital).
C.H.S.P.: Centre hospitalier de soins psychiatriques (psychiatric hospital).
R.T.F.: Ressource de type familial (family-type resource).
R.I.: Ressource intermédiaire (intermediate resource).
Other public resources: public resource managed by an institution that is not an R.T.F. or an R.I. Examples:
a R.A.C. Résidence avec assistance continue (continuous care home), an internat. Exceptionally, detention
centres and halfway houses can be considered “other public resources”; in this case, there is no other
managing institution.
Managing institution: institution responsible for a public residential resource, whether similar to an R.T.F.,
R.I. or any other type of public resource being managed by an institution.
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Reference: Régie du logement.
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Other private resources: private living arrangements where admission and cost are not managed by the
health and social services network.
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3. Sources of Information
Relatives, friends and social and health workers in the psychosocial assessment context.
4. Circumstances and Reasons for the Request
Circumstances and reasons for the request – examples: death of the spouse who filled the incapable
person’s need for protection; discovery of a situation where an incapable person is being abused; an event
causing sudden incapacity; an event with a significant impact on the person’s financial or legal situation
(legal proceedings, inheritance, etc.); extravagance.
5. Legal Situation
This section is intended to provide information about the legal instruments used to assist incapable persons
in certain civil acts or in the administration of their property and about the legal or administrative proceedings
affecting them that correspond to articles 2130 and 2131 of the Civil Code of Quebec. If they are available,
you may attach a copy of the legal documents mentioned below.
Mandate given in anticipation of incapacity: power of attorney drafted before the person becomes incapable.
May be notarial or a private writing before witnesses. It must be homologated by the court once incapacity
has been observed in order to come into force.
Homologated mandate given in anticipation of incapacity: mandate given in anticipation of incapacity
rendered effective by the court.
General power of attorney: notarial or private writing prepared before the person became incapable. Power
of attorney appoints an administrator of property and determines their powers.
Bank power of attorney: administrative document provided by the financial institution concerned, completed
and signed by the person before becoming incapable. Names one mandatary and defines his powers
(usually regarding bank account transactions).
Administration of social security benefits and compensation: the laws and regulations governing social
security benefits and compensation allow the appointment of an administrator. Examples of such laws are
the Old Age Security Act, the Act respecting the Quebec Pension Plan, the Act respecting income support,
employment assistance and social solidarity, the Automobile Insurance Act, the Act respecting industrial
accidents and occupational diseases and the Crime Victims Compensation Act. The departments,
organizations and programs concerned – such as the Old Age Security Program (including the basic Old
Age Security pension [OAS], Guaranteed Income Supplements and Allowances), the Régie des rentes du
Quebec (RRQ), the Société de l’assurance automobile du Quebec (SAAQ) and the Commission de la santé
et de la sécurité du travail (CSST) – have medical and psychosocial assessment forms to be completed for
that purpose. The person concerned and the administrator approached must be volunteers.
Court-ordered administration by the spouse: administration by the person's spouse, authorized under articles
399 and 444 of the Civil Code of Quebec.
Administration without power of attorney or a written mandate or appointment – examples: administration of
the budget by the spouse or a friend or family member, business management, etc.
Legal proceedings or orders in effect – examples: divorce, adoption, bankruptcy, seizure, mortgage
repossession, child custody, alimony, criminal case, commitment, temporary commitment, request for
medical care, etc.
Administrative proceedings - examples: claims for compensation from the CSST, SAAQ, Income Security,
Régie du logement; cases before the Tribunal administratif du Quebec (TAQ); eviction notices; legal orders.
Specify in the space provided: the type of proceeding, the organization or court concerned, the role of the
person (petitioner, respondent or impleaded party) and the date of the hearing, if known.
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6. Financial Situation
This section is intended to document the financial situation of the person using information known by the
evaluator and to be helpful in documenting the need for protection. It does not involve preparing exhaustive
financial statements.
Main sources of income
• Old age pension: include the base amount and, where applicable, the guaranteed income supplements.
• Other sources - examples: allowances, alimony, employment income, Canadian Veteran’s Disability
Pension Program.
Monthly expenses
• Current accounts - examples: utilities like electricity, heat, telephone, cable service.
• Personal expenses - examples: food, clothing, transportation, recreation, allowance for personal
expenses.
• Other expenses - examples: premiums for insurance (car, home, income, drug, life), property
maintenance, snow removal, condo fees, car costs, payment of alimony, etc.
Property: assets
• Bank accounts: if the financial institution address can’t be found with the account number, please write it.
• Investments- examples: RRSP, RIFF, bonds, equities, etc.
• Movables and valuable objects - examples: antiques, art, jewelry, furs.
• Property - examples: bungalow, semi-detached home, duplex, triplex, condominium; land; secondary
residence.
• Other assets - examples: car, business, farm, life insurance redemption, funeral and burial pre-
arrangements, etc.
Property: liabilities
• Unpaid bank loan: an amount borrowed by the person from a financial institution.
• Unpaid loans from other sources: an amount borrowed by the person from an individual or business.
• Accounts payable - examples: current accounts, credit cards, overdue accounts.
7. Significant Events in Psychosocial History
An event in the psychosocial history of the person is significant if it is linked with the incapacity and need for
protection. It may be associated with how rooted the person is in his community (number of years in current
area, recent immigration, homelessness); a problematic family history; the level of education (specialization,
level of education attained, illiteracy, undereducation); the need for health care or social services (frequent
hospitalizations, resistance to assistance or services offered, mistrust of social workers, relatives or friends,
frequent care or commitment orders, substance abuse – psychotropic drugs or alcohol), etc.
8. Interpersonal Relations
Composition of the family and social network: spouse, number and approximate age of children, living or
deceased parents, siblings; grandparents if still alive, friends or people providing social support; description
of the relationship (significant, fairly significant, insignificant or nonexistent) and any other relevant aspect
(depletion, geographic distance, etc.); member of a religious or cultural community, etc.
Current family dynamics: description of particular situations related to the need for protection and their effect
on the person. Examples: dysfunctional family, conflicts, diverging interests, violence, abuse.
Current social roles: current capacity of the person to perform social roles. Reports or observations of facts
related to the person’s capacity to take on social responsibilities and exercise his rights, according to
whether the person is a spouse, parent or has dependents; family breadwinner or in charge of managing the
budget; landlord or tenant; employee, manager or employer; according to his other commitments (contracts,
tacit agreements, etc.)
Person’s current capacity to express wishes: ability to express desires, in terms of obstacles of an emotional
nature. Example: a person who doesn’t dare express his wishes due to a particular family dynamics or out of
Le Curateur public du Quebec 5 0021-DGP-2003-10
fear of being reprimanded, rejected or isolated. Do not confuse with a functional capacity to express one’s
wishes, linked to functional causes such as dysphasia, dysarthria or other speech or hearing disorder.
9. Autonomy-Related Observations3
This purpose of this section is to document the person’s autonomy on the basis of the evaluator’s
observations. Do not conduct a systematic assessment of the person’s functional autonomy, such as is
necessary for an allocation of resources, but rather provide information that may be useful in assessing his
need for protection.
Mobility: refers to the person’s capacity to move (walk, transfer, etc.). Specify any technical assistance used.
ADL: activities of daily living. These include activities related to eating, dressing and hygiene (toilet, personal
appearance, oral hygiene). Activities concerning movement are handled in the mobility section.
DDS: domestic daily skills. These include activities involving the purchase of goods and services,
preparation of meals, laundry, house work, use of the telephone, moving around the outside of the home
and managing medication.
10. Opinion of the Person as to the Institution of Protective Supervision
Once the Opinion of the person as to the institution of protective supervision section is filled out, you should
be able to answer the following questions on the person's capacity to communicate: does the person
recognize or deny his needs? Understand the current process? Express fears about this? Believe that his
interests are being met? Does the person oppose this process? Intend to contest any future request to
institute protective supervision? Moreover, article 257 of the Civil Code of Quebec requires informing the
person about decisions relating to the institution of protective supervision.
11. Conclusion of the Person Who Completed the Assessment Regarding Incapacity and the Necessity
of Protective Supervision
In addition to article 270 of the Civil Code of Quebec, on which this assessment approach is based, the
Conclusion of the person who completed the assessment regarding incapacity and the necessity of
protective supervision satisfies the principles of articles 256, 257 and 259 of the Civil Code of Quebec.
ASSESSMENT OF INCAPACITY (INCLUDING THE DEGREE OF INCAPACITY)
This section should include the elements, observations and facts documented or reported by a reliable
source that support the opinion regarding incapacity and the degree of incapacity (total or partial) and agree
with the results of the medical assessment by specifying details or nuances and establishing the facts: Is the
person able to command respect for one’s opinions? Make decisions that will affect him? Sign and honor a
contract? Claim benefits? Exercise and defend his rights? Testify in court?
NECESSITY OF PROTECTIVE SUPERVISION
Highlight the reasons supporting of the need for protection, in view of the assessment of the person’s
incapacity:
- his isolation (existence and support by family and friends; relations with them)
- his legal situation (adequate or inadequate administration of his affairs with or without a mandate, power
of attorney; legal proceedings underway)
- his financial situation (composition and state of assets; complexity of management)
- his capacity to assume social roles and responsibilities
- his capacity to express his wishes.
How would protective supervision meet the person’s need for protection better than other measures? Would
private measures be a good idea? Should the status quo be considered?
EMERGENCY INTERVENTION
3
Classification des résultats de soins infirmiers CRSI – NOC , directed by Marion Johnson and Meridean Maas, 1999, Collection Démarche soignante,
Masson-Paris, ISBN : 2-225-83258-7.
Le Curateur public du Quebec 6 0021-DGP-2003-10
Applies to any situation requiring immediate intervention, whenever harm will definitely or probably result.
Identify the prejudice or risks of serious prejudice to the person, his property or the exercise of his civil rights.
Emergency intervention – examples:
- abuse by friends or family (financial or physical abuse, including harassment, intimidation, and threats,
retaliation or isolation);
- threat to safety, physical integrity or health (situation possibly linked to the person’s behavior or
judgment or his functional autonomy and degree of compensation);
- state of affairs (possibly linked to the person’s behavior and judgment – extravagance, stripping of
assets, negligence – or unintentional poor management by the administrators or mandataries);
- necessity of representing the person in a legal or administrative proceeding underway;
- property in need of repair or measures for its preservation.
Prejudice: harm to one’s rights and interests.
Serious prejudice: harm that is serious enough for the person who is its victim, or someone else on his
behalf, to be authorized to seek a remedy in order to reduce or lessen its effects. This involves more than
just inconveniencing or upsetting the person.
12. Identification of a Possible Legal Representative
The opinion of the evaluator as to the possibility or desire of someone to be appointed as private legal
representative: does the proposed representative understand the responsibilities of a legal representative?
Have the skills required for representing the interests of the person? Have demonstrated that he can act on
behalf of the person? Is there evidence of his acts?
13. Person Who May Be Called to the Meeting of Relatives, Persons Connected by Marriage or Friends
The notice of the meeting of relatives, persons connected by marriage or friends is based on articles 226
and 266 of the Civil Code of Quebec.
To obtain a quorum, a meeting must be made up of a minimum of five members. It is therefore important to
call people who demonstrate an interest in the person.
14. Identification of the Professional Who Completed the Assessment
The signature of the professional who made the assessment must appear on each of the completed four
printed copies of the form.
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