Helping an LGBTQ+ person with dementia plan ahead

Advice and practical tips for planning ahead when supporting an LGBTQ+ person living with dementia, including appointing someone to make decisions.

There are legal tools to protect the interests and wishes of the person with dementia. This can include wishes that relate to the person’s identity and needs as a LGBTQ+ person.

It’s important to make plans as early as possible, to prepare for a time when the person will need much more support and may not be able to make decisions for themselves.

Appointing a person to make decisions

The person may want to appoint you, or another person who is important to them, to make decisions on their behalf when they are no longer able to make them. For instance, they may want you to ensure that they wear clothes that fit their gender identity.

They can create a Lasting power of attorney (LPA) in England and Wales, or an Enduring power of attorney (EPA) in Northern Ireland.

There are two types of LPA – one for decisions about health and welfare (covering issues such as day-to-day care and treatment) and one for decisions about property and financial affairs (covering issues such as bills, bank accounts and selling property).

However, the EPA in Northern Ireland currently only covers property and financial affairs.

Making decisions about treatment

To record the person’s wishes about treatments they don’t want to receive, they can create an advance decision to refuse treatment in England and Wales, or an advance directive in Northern Ireland.

Health professionals in England and Wales must follow the person’s wishes if the person is unable to make a decision for themselves at the time. These wishes should also be followed in Northern Ireland. To make sure this happens, it’s important that the advance decision or directive is recorded in writing and includes certain information. 

Recording other wishes a person might have

The person with dementia may have other important wishes. For example, they might want to specify:

  • how they wish to dress
  • the pronouns they would like people to refer to them by (for example, ‘he’, ‘she’ or ‘they’)
  • any prosthetics.

It’s a good idea to record the person’s wishes. An advance statement in England and Wales, or living will in Northern Ireland, is a document that lists a person’s general wishes and preferences for the future.

Advance statements and living wills are not legally binding, but they should be taken into account if future decisions are made on a person’s behalf. If a decision is made that goes against an advance statement or living will, there must be a very good reason for this.

Gender Recognition certificates

A person who is trans can apply to the government’s Gender Recognition Panel for a Gender Recognition Certificate if they meet certain criteria. This gives the person the right to be treated legally as someone of their own gender.

Not all trans people will have a Gender Recognition certificate, and there are lots of reasons why a person might not have applied for one. It’s important to remember that a trans person does not need to have a Gender Recognition Certificate to have their gender identity respected by others.

They also don’t have to have a Gender Recognition Certificate to be legally protected from discrimination.

Learn more about planning ahead with dementia

When you have dementia, planning ahead can help you make decisions about care and treatment in the future. This may include writing an advance decision or advance statement or making a Lasting power of attorney (LPA). Read our information to learn more.

Read our information
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