Health and Welfare LPA

What it is

A document appointing one or more attorneys to make decisions about your personal welfare if there comes a time when you cannot make them yourself. That can cover daily matters like diet and activity, and much bigger ones like moving into residential care or consenting to treatment.

How it works

• It has to be registered with the Office of the Public Guardian before it can be used at all.
• Your attorneys can only use it when you lack the capacity to make the particular decision yourself. While you can decide, you decide.
• Attorneys have no authority to consent to or refuse life sustaining treatment unless you expressly give them that authority in the form. You choose, and it is a decision worth thinking about properly rather than ticking.
• You can leave preferences, which your attorneys should consider, and instructions, which they must follow. Instructions that go beyond an attorney’s powers get severed by the Public Guardian before registration.
• The certificate provider who signs the form cannot be an attorney, a family member, a business partner, or an employee of a care home you live in.

What happens if you do nothing

You can only make an LPA while you still have capacity. Miss that window and nobody, including a husband or wife of fifty years, can simply step in. The only route is an application to the Court of Protection to appoint a deputy, which is slower, more expensive, more restrictive and supervised. Deputies are far more commonly appointed for finances than for welfare, so families are often left with no formal voice in care decisions at the moment they need one most.

Health and welfare LPAs are also the neglected half. Far more financial LPAs are registered than health and welfare ones.

Where specialist advice matters

• If you already have an advance decision refusing treatment, the order in which the two documents were made changes which one prevails. This needs checking, not assuming.
• Appointing attorneys jointly means every decision needs every signature, and one attorney dropping out can stop the document working entirely unless replacements are named.
• Family disagreement, unequal involvement of adult children, or any concern about pressure should be raised at the outset rather than discovered at registration.