Have you considered who would make important decisions about your health and care if you were no longer able to make them yourself?
It can be an uncomfortable subject, but planning ahead gives you greater control over your future. A Lasting Power of Attorney for Health and Welfare allows you to choose people you trust to make certain decisions if illness, an accident or another condition affects your mental capacity.
What Is a Health and Welfare LPA?
A Lasting Power of Attorney, commonly known as an LPA, is a legal document through which you appoint one or more people as your attorneys.
A Health and Welfare LPA can give your attorneys authority to make decisions about matters such as:
• Your medical care and treatment
• Where you live and receive care
• Your daily routine, including washing, dressing and eating
• Support from health and social care services
• Who you have contact with
• Life-sustaining treatment, where you specifically give them that authority
Unlike a Property and Financial Affairs LPA, a Health and Welfare LPA can only be used when you cannot make the particular decision yourself.
Why Might You Need a Health and Welfare LPA?
Mental capacity can be affected unexpectedly by an accident, stroke or serious illness. It can also change gradually because of a condition such as dementia.
Without an LPA, you do not get to choose in advance who will have formal authority to make health and welfare decisions for you.
Many people assume that their spouse, partner or adult children can automatically take control because they are their “next of kin”. However, being next of kin does not by itself give someone legal decision-making authority.
Where no authorised attorney exists, health and care professionals may need to make individual decisions in your best interests. They should consider your wishes and consult the people close to you, but your relatives may not have the final say. More complex or disputed decisions may need to be referred to the Court of Protection.
What Can Happen Without a Plan?
When someone suddenly becomes unable to manage their own affairs, their spouse, partner or children do not automatically gain authority to access accounts or make decisions for them.
Without a valid LPA or other legal authority, relatives may need to apply to the Court of Protection. The application can involve court fees, possible hearing costs, paperwork and delays at a time when urgent decisions may already be required.
The greatest potential loss is not only financial. It is the opportunity to make your own wishes clear while you are still able to do so.
You Remain in Control While You Have Capacity
Creating an LPA does not mean handing over control of your life immediately.
Your Health and Welfare attorneys can only make a decision when you lack the mental capacity to make that particular decision yourself. Capacity is specific to the decision and the time at which it needs to be made.
You may, for example, be unable to understand a complicated medical decision while remaining perfectly capable of making choices about your meals, clothing or daily routine.
Your attorneys must also support you to participate in decisions as much as possible and must always act in your best interests.
What Are the Benefits of Having an LPA?
Greater Peace of Mind
You can feel reassured knowing that people you have personally chosen will be able to speak and make decisions for you if necessary.
More Control Over Your Future
You can record instructions and preferences that help your attorneys understand how you would like decisions to be made.
Someone You Trust Can Advocate for You
Your attorneys can communicate with medical and care professionals, ask questions and help ensure your views are properly considered.
Less Uncertainty for Your Family
Without clear legal authority, family members may be uncertain about who should speak for you or what you would have wanted.
Fewer Risks of Disagreements
Choosing your attorneys and discussing your wishes in advance can reduce the likelihood of disputes between relatives or professionals during an already difficult time.
Who Should You Choose as Your Attorney?
Your attorney could be:
• Your spouse or partner
• An adult child or another relative
• A close friend
• A suitable professional
The person should be someone you trust to remain calm, listen carefully and make decisions based on your wishes and best interests rather than their own preferences.
You can appoint more than one attorney and decide whether they must make decisions together or can sometimes act separately. It is important to discuss the role with them before including them in your LPA.
What About Life-Sustaining Treatment?
A Health and Welfare LPA contains a specific choice about life-sustaining treatment.
You must decide whether your attorneys should have authority to consent to or refuse treatment intended to keep you alive, or whether those decisions should remain with the doctors responsible for your care.
Life-sustaining treatment might include major surgery, artificial ventilation or other treatment needed to keep you alive. The appropriate treatment will always depend on the circumstances at the time.
This is an important part of the form and should be considered carefully.
How Do You Set Up a Health and Welfare LPA?
The process generally involves:
1. Choosing your attorney or attorneys
2. Deciding how they should make decisions
3. Recording any instructions or preferences
4. Choosing a certificate provider to confirm that you understand the LPA and are not being pressured
5. Completing and signing the document correctly
6. Registering it with the Office of the Public Guardian
The LPA cannot be used until it has been registered. Mistakes can delay registration or cause an application to be rejected, so professional guidance may be valuable where your wishes or family circumstances are complicated.
Don’t Leave It Until You Need It
A Lasting Power of Attorney can only be created while you have the mental capacity to understand what it means and decide who should act for you.
Once capacity has been lost, it is too late to make an LPA. Your family may then need to explore a Court of Protection application or rely on professionals to make individual best-interests decisions.
Making an LPA is not about expecting the worst. It is about choosing who you trust, making your wishes clearer and giving your family the authority and guidance they may need.
Get Help Setting Up Your LPA
Safeguarding Futures can explain your options, help you choose the right arrangements and guide you through the process from start to finish.
This article provides general information rather than legal advice. Lasting Powers of Attorney and the Mental Capacity Act 2005 apply in England and Wales; different arrangements apply elsewhere in the UK.
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