How a Lasting power of attorney can help if you have dementia

A Lasting power of attorney (LPA) is a legal tool that lets you choose someone you trust to make decisions for you. There are two different types of LPA: property and affairs LPA and health and welfare LPA. LPAs can make things easier for you and the people you are close to as your dementia progresses.

Lasting power of attorney
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What is a lasting power of attorney?

Many people with dementia will reach a point where they can no longer make some decisions for themselves. This is known as lacking ‘mental capacity’ to make those decisions. When this happens, someone else – often a carer or family member – will need to decide on behalf of the person with dementia.

A Lasting power of attorney (LPA) is a legal tool that lets you choose someone (or several people) you trust to make decisions for you. This person is referred to as your ‘attorney’, and you can choose what decisions they can make for you.

There are two different types of LPA:

  • Property and affairs LPA. This lets the person you appoint make decisions about your property and finances.
  • Health and welfare LPA. This lets the person you appoint make decisions about your care and medical treatment.

You can choose to make both types or just one. You can appoint the same person to be your attorney for both, or you can have different attorneys. You can find out more about these types of LPAs below.

All LPAs must be registered at the Office of the Public Guardian (OPG) before they can be used. The OPG is a government body that is responsible for the registration of LPAs (for more information see ‘How do I make an LPA?’).

Who can make an LPA?

You need to be over 18 and have what is called ‘mental capacity’ to make an LPA. This means that you must be able to understand what an LPA is and what making one means. 

When should I make an LPA?

Dementia is progressive which means that it will become more difficult for you to make plans and decisions over time. It is therefore a good idea to start thinking about making an LPA as soon as you can.

Talking about LPAs with your family or close friends can be a good way to think about what you want for the future. It will also help them to know and understand your wishes and preferences.

Do you live in Northern Ireland?

In Northern Ireland, the laws around powers of attorney are different. So if you live in Northern Ireland, please read our information about Enduring power of attorney and controllership.

Find out more

What are the different types of powers of attorney?

Property and affairs LPA

What is a property and affairs LPA?

A property and affairs LPA covers decisions about your finances and property.

If there comes a time when you can’t manage your finances anymore, the person you appoint as your attorney will be able do this for you. This can include managing your bank accounts, paying your bills, collecting your income and benefits, or selling your house.

However, if you want to, you can limit the decisions the attorney can make, or when they can make them.

Can a property and affairs LPA be used to make decisions that I can make myself?

There are two different options for property and affairs LPAs. You must select one of these on the form. These two options are explained below:

  • Your attorney can only make decisions for you when you can’t make them for yourself.

  • Your attorney can also make decisions that you can make for yourself, if you allow them to. This can be a good way to give yourself extra support.

Health and welfare LPA

What is a health and welfare LPA?

A health and welfare LPA allows your attorney to make decisions on your behalf about your health and care, if you are unable to make these decisions for yourself.

A health and welfare attorney could make decisions about where you live, for example, or your day-to-day care and medical treatment. 

Can a health and welfare LPA be used to make decisions that I can make myself?

Unlike a property and affairs LPA, a health and welfare LPA cannot be used to make decisions about your welfare or treatment that you can make for yourself.

Can a health and welfare attorney make decisions about life-sustaining treatment?

You can give your health and welfare attorney the power to accept or refuse life-sustaining treatment on your behalf. You will be asked whether you wish to do this or not on the form, and you will need to state what you choose clearly.

This is a very significant responsibility. Take time to discuss this question with the person you’ve chosen as your attorney.

How does a health and welfare LPA affect an advance decision?

You may have already refused certain future treatments in an advance decision before making a health and welfare LPA. If so, you need to think about how the advance decision and the LPA will work together.

The LPA will override your advance decision if you give your attorney the power to accept or refuse treatment that is covered by your advance decision.

You may need to take legal advice if you are concerned about any confusion between your advance decision and your LPA.

Enduring power of attorney (EPA)

What is an enduring power of attorney?

Enduring powers of attorney (EPAs) were in place before Lasting powers of attorney (LPAs). 

EPAs only cover decisions about finances and property (like the property and affairs LPA). They do not cover health and welfare decisions.

Can I still make an EPA?

It’s not possible to make an EPA anymore. However, if you made one before 1 October 2007 it can still be used (as long as it was correctly filled in).

If I have an EPA, do I need to make an LPA ?

If you have a valid EPA, you don’t need to make an LPA unless you want to make changes to it.

For example, you may want to change who can make decisions for you or change what powers you give them.

If you have an EPA, you might also want to think about making a health and welfare LPA to cover decisions about your care and medical treatment.

Can an EPA be used to make decisions that I can't make myself?

Yes, your attorney will need to register your EPA with the OPG if you lose mental capacity to manage your finances.

Your attorney can also use it to make decisions with your permission if you still have mental capacity to make those decisions yourself (unless your EPA says something different).

General or ordinary powers of attorney

What are general or ordinary powers of attorney?

In addition to LPAs, you may come across something called a general or ordinary power of attorney.  These can also give someone permission to manage your property and finances (not health and welfare) on your behalf.

They might be used, for example, if you are going abroad for some time and want someone to look after things while you are away.

Can general or ordinary powers of attorney be used to make decisions that I can't make myself?

Unlike an LPA or EPA, general or ordinary powers of attorney cannot be used if you become unable to make decisions about your property or finances in the future.

When you have dementia, an LPA is a better option as it allows your attorney to make or continue to make certain decisions for you if you cannot make them yourself.

Why should I make an LPA?

After a diagnosis of dementia it is a good idea to plan for the future. It may be hard, but it can also be reassuring to know that you have made your wishes and preferences clear.

It can also help you to know that you have chosen people you trust to make decisions for you when you need them to. Planning ahead can make things easier for your family and friends as well.

What happens if I don't make an LPA?

Although it can be difficult to think about the future, and to plan for life with dementia, it is important. Planning can make things much easier as your condition progresses.

If you don’t make an LPA, and later become unable to make certain decisions for yourself, there may come a time when no one can legally make those decisions for you. This can make things difficult and very drawn-out, such as paying bills or care costs, or making decisions about your future care.

If this happens, someone may need to apply to the Court of Protection to become your deputy.

What is the difference between a deputy and an attorney?

Becoming a deputy gives someone similar powers to an attorney. A family member or friend can apply to be your deputy, or a professional may be appointed.

However, there are important differences between a deputy and an attorney:

  • The process of becoming a deputy is more time-consuming and expensive than an LPA.
  • The deputy is chosen by the court, not by you.
  • A deputy must also do some other tasks, such as paying an annual fee and submitting an annual report. This means it is usually cheaper and easier for someone to be an attorney rather than a deputy.
  • It’s unusual for a deputy to be appointed to deal with decisions about your health and welfare. A deputy is normally only appointed to deal with your property and finances.

If you have not made either a health and welfare LPA, or an advance decision that applies, health or social care professionals will normally make care and treatment decisions for you – if you are unable to decide for yourself.

In this instance, the professionals would make decisions based on what is in your ‘best interests’. They would still need to consider your wishes and feelings (including the ones in any advance statement you have made) but it would be these professionals who would make the final decision.

What are the benefits of making an LPA?

Lasting powers of attorney (LPAs) can help to make things easier for you and the people you are close to as your dementia progresses. There are many benefits of having an LPA in place – some of these are listed below.

  • It can be reassuring to know that, if you are unable to make a decision for yourself in the future, someone you have chosen and trust will make that decision for you.
  • With a property and affairs LPA, you can allow your attorney to make decisions even if you can still make them yourself. You don’t have to choose this option but it can be a useful way of giving yourself some extra support. It can also help your attorney to get familiar with all your financial and legal arrangements.
  • Making an LPA now will make things easier for the people close to you in the future. It will be more expensive, difficult and time-consuming for them to get permission to act on your behalf when you are not able to give your consent.
  • Making an LPA can start discussions with your family or others about what you want to happen. This means decisions they have to make in the future will be based on your wishes.

Are there other ways to plan ahead?

Lasting powers of attorney are not the only way to plan for the future. You can make arrangements, choices and decisions about your property, finances, future care and medical treatment. For example, you can:

  • make a will (or update a will you have already made)
  • make sure that your finances are in order. This might include getting financial advice (see 'Lasting power of attorney - useful resources' for some suggestions about how to do this)
  • make an advance decision or advance statement. These allow you to refuse certain medical treatments or to express your preferences about your future care and things that are important to you.
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