Families usually arrive at this subject with one word in mind: guardianship. It is the word hospitals use, the word relatives use, and often the word the family has been told to act on.
It is also the most intrusive option Alberta offers, and the law is deliberately built so that it is the last one considered rather than the first. A court must be satisfied that less intrusive and less restrictive supports are not suitable.
There are five rungs. Two of them do not involve a court at all.
Rung 1: Supported decision-making
For an adult who still has capacity but needs help understanding information or thinking a decision through.
The adult identifies one to three people they have a trusting relationship with, and authorises them to help with personal, non-financial decisions. The supporter can gather information, help the adult understand it, and communicate the adult's decision. The decision remains the adult's.
No court. No capacity assessment. No fee. It is done by signing Form 1, the Supported Decision-making Authorization, OPG5557. It is ended by signing Form 2, OPG5558.
This is the most under-used tool in the whole framework, and it is the right answer far more often than people realise. An adult who is overwhelmed by paperwork, or anxious in medical appointments, or slower to process information, may need exactly this and nothing more.
Its limit is that it depends on the adult having capacity. If capacity is lost, supported decision-making must give way to something else.
Rung 2: Co-decision-making
For an adult whose capacity is impaired but not absent: someone who can make personal decisions with help, but not alone.
The adult does not lose the authority to make their own decisions. They share it with a co-decision-maker.
This one does need a court order, from the Court of King's Bench, and a capacity assessment on Form 3, OPG5559, the co-decision-making report. The filing fee is up to $300.
Consent runs both ways and it is mandatory. The adult must consent, Form 11, and the proposed co-decision-maker must consent, Form 12. The adult can withdraw consent at any time, Form 13. It is available only where there is no personal directive, guardianship or trusteeship already in place.
It ends if the adult loses the capacity to make decisions even with support.
Rung 3: Specific decision-making
For a single decision, now, where nobody has authority and something has to happen.
It covers health-care procedures, examinations and treatments, and temporary placement into or discharge from a residential facility such as a nursing home, rehabilitation centre, approved hospital, auxiliary care or licensed group home.
No court. Capacity is assessed by a health-care provider such as a doctor, nurse practitioner or dentist, not by a designated capacity assessor, using Form 10, OPG5566, alongside Form 6, OPG5562.
Who decides is set by a ranked list of nearest relative: spouse; adult interdependent partner; adult son or daughter; father or mother; adult brother or sister; grandfather or grandmother; adult grandson or granddaughter; adult uncle or aunt; adult niece or nephew.
It is available only where the adult has no agent under a personal directive and no guardian.
There are firm exclusions. Specific decision-making cannot be used for psychosurgery, sterilisation unless life-saving, tissue transplant unless life-saving, experimental activities, or end-of-life decisions.
And there is a clock: a health-care provider can act on the decision if a person who disagrees does not take action within seven days.
This is the mechanism that gets a hospital discharge unstuck while a longer-term arrangement is sorted out. It is a bridge, not a destination.
A related route, new since 1 April 2026: the Public Trustee may make specific financial decisions for an adult who is incapable of making financial decisions related to their living arrangements, where no court-appointed trustee and no attorney under an enduring power of attorney has authority. Capacity for this is assessed by a doctor or nurse practitioner on Form 10.
Rung 4: Guardianship
A court order for personal, non-financial decisions, over the seven statutory areas. Needs Form 4, the Capacity Assessment Report, plus the application, affidavit, guardianship plan, consents and personal references, and a criminal record check.
Rung 5: Trusteeship
A court order for financial decisions, applying to all of the adult's real and personal property in Alberta. Same assessment report, Form 4, plus the trusteeship plan, consents, personal references and an inventory, with background, credit and reference checks, and continuing accounting obligations to the court.
Both are covered in more detail in guardianship or trusteeship: which one does your family need.
The two documents that make most of this unnecessary
Everything above is what happens when someone loses capacity without having planned for it.
An enduring power of attorney, made under the Powers of Attorney Act, gives another person authority to make financial decisions on your behalf, either immediately and continuing after capacity is lost, or only on loss of capacity. If one exists, trusteeship is generally unnecessary.
A personal directive, made under the Personal Directives Act, names an agent to make personal decisions if you cannot: medical treatment, where you live, care of minor children, recreation, employment, education and other personal matters. It activates when a capacity assessment confirms, through a Declaration of Incapacity, that you are unable to make those decisions. If one exists, guardianship is generally unnecessary.
Without either, Alberta's own guidance is blunt: a family member or friend might have to go to court, and that takes time and money.
The cheapest thing anyone reading this can do is make both documents, for themselves, this month, while it is straightforward. See the paperwork that prevents a court application.
How to work out which rung you are on
Three questions, in order.
Does the adult still have capacity for the decisions in question? If yes, guardianship is not available and not appropriate. Look at supported decision-making, or at making a personal directive and an enduring power of attorney now.
Is there already a personal directive or an enduring power of attorney? If yes, the agent or attorney may already have authority. Find the documents before you start an application.
Is this one urgent decision, or an ongoing inability to decide? One decision may be handled by specific decision-making. An ongoing pattern across several areas is what guardianship and trusteeship exist for.
Where this sits with us
We help families work out which of these fits their situation, and we conduct the designated capacity assessments the court routes require. We do not give legal advice and we do not draft or file court documents as a legal service.
If what you need is a personal directive or an enduring power of attorney drafted, that is a lawyer's work, and Alberta also publishes free forms. We will tell you that rather than sell you something else.
Talk it through with us before you commit to the most intrusive option on the list.