Lasting power of attorney for health and welfare

What is a lasting power of attorney?

A lasting power of attorney (LPA) for health and welfare is a legal document that lets you give someone you trust the power to make decisions for you.

Making an LPA keeps you in control if you lose the ability (you lack mental capacity) to make decisions or speak for yourself because of an accident or illness.

An LPA for health and welfare allows someone to make decisions about:

• where you live and are cared for
• your daily routine and diet
• medical care and treatment options
• people you see and spend time with

If you have not made an LPA then the professional in charge of your care will be the decision maker if you lose mental capacity.

Why people make a lasting power of attorney for health and welfare

You might lose the ability to make decisions or speak for yourself because of an accident or illness. If this happens and a decision needs to be made about your treatment or care your family should be involved, but they will not have the final say.

Some people decide to make an LPA because they:

• want to stay in control
• have seen relatives left out of important decisions
• want to make things easier for their family
• are getting older and want to be prepared
• have been diagnosed with a serious illness

By making an LPA you can make sure that the people who know you best are involved in your care and can make important decisions for you.

When I was diagnosed with dementia I was really worried about someone I didn’t know being in charge of my care. Giving my daughter lasting power of attorney has given both of us such peace of mind knowing that once I can no longer make decisions for myself, she’ll be speaking for me.

Brenda, 76

Make a lasting power of attorney for health and welfare

Anyone over the age of 18 with mental capacity can make an LPA. To make one you need to:

1. Choose one or more people you trust (known as attorneys)
2. Complete the form
3. Register the form with the Office of the Public Guardian (it takes up to 20 weeks if there are no mistakes in the application)
4. Tell your relatives, GP and others involved in your care

In England and Wales you can make a lasting power of attorney yourself using the GOV.UK website.

Fees

If you complete the form yourself it will cost £82 to register. You may be able to get a reduction or exemption.

It’s important to register your form with the Office of the Public Guardian once it’s finished, otherwise it cannot be used.

Using a solicitor

You do not need to use a solicitor, but some people are more comfortable using one. They can charge around £500 (sometimes it’s much more) and will use the same government form.

Change or end your lasting power of attorney

The GOV.UK website explains what to do if you want to make changes or end your lasting power of attorney.

Lasting power of attorney and living will (advance decision)

An LPA for health and welfare lets you give someone you trust the power to make decisions for you if you cannot make decisions for yourself. It covers any decision about treatment and care, for example where you live, your daily routine and treatment decisions.

A living will is a form written by you to refuse medical treatments in advance. It only covers decisions about refusing specific medical treatments.

They are both legally binding, and cannot be used unless you lose the ability to make decisions or speak for yourself because of an accident or illness.

If you need support deciding which form is right for you contact us:

• phone on 0800 999 2434
• email at info@compassionindying.org.uk

Can I have a lasting power of attorney and a living will?

Yes, you can have both an LPA and a living will, they work well together.

If you make an LPA for health and welfare it is important that you tell your attorney what you do and do not want to happen to you. This will help the person you choose as your attorney to make important decisions, and will prove to doctors and care staff that they are acting in your best interests.

You should make an advance statement to say what care you want, and a living will (advance decision) if there are specific treatments that you do not want. You can say that your attorney must follow your advance statement and living will in section 7 of the LPA form.

The role of a lasting power of attorney

It is important that whoever you choose as your attorney is aware of the responsibilities and will act according to your wishes.

Responsibilities of an attorney

If you lack mental capacity to make decisions for yourself, then your attorney will be able to make any decisions about your treatment and care. They must act in your best interests.

These decisions might include:

• where you live and are cared for
• your daily routine and diet
• medical care and treatment options
• people you see and spend time with

You can add any instructions that your attorney must follow, or any preferences that you’d like them to take into account in section 7 of the LPA form.

How to choose an attorney

Your attorney can be anyone over the age of 18 including a friend or relative.

It is important to think about whether the person:

• understands and respects your wishes
• will stand up for what you want, even if a doctor disagrees
• has the time to support you and be involved in your long-term care

You can choose one or more attorneys. If you have more than one, you will need to decide how they make decisions in section 3 of the LPA form.

If you do not have someone who can be your attorney then there are other ways that you can plan ahead.

Rights of an attorney

If you are the attorney for someone who no longer has mental capacity to make care and treatment decisions you should let their care team know about your role (you should show them the form). The treatment and care options available should be explained to you so you can make an informed decision on the person’s behalf. You cannot demand treatments on their behalf (for example, you cannot demand CPR is given if a doctor decides it is not medically appropriate). You have the right to access medical records if needed.

If someone (for example a doctor or care home manager) thinks you are not acting in the person’s best interests they can challenge your decision. If this happens you can ask for a best interests meeting. At this meeting you will need to explain why you think the decision is in the person’s best interests and may need to provide evidence (for example an advance statement or living will).

If after this meeting you have still not reached an agreement you can:

• ask for a second opinion
• get a third party to help resolve the disagreement (mediation)
• apply to the Court of Protection to make a decision
• make a formal complaint to the hospital or care provider

If you need support as an attorney contact us by:

• phone on 0800 999 2434
• email at info@compassionindying.org.uk