Supporting a lesbian, gay, bisexual or trans person with dementia

10. Planning ahead

There are a number of legal ways to protect the interests and wishes of the person with dementia. It is 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 themself.

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. They can create a Lasting power of attorney (LPA) in England & 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.

For more information see factsheet 472, Lasting power of attorney, or in Northern Ireland see factsheet NI472, Enduring power of attorney and controllership.

Decisions about treatment

To record the person's wishes about treatments they do not wish to receive, they can create an advance decision to refuse treatment in England and Wales, or advance directive in Northern Ireland.

Health professionals in England and Wales must follow the person's wishes if they are unable to make a decision for themself at the time. They should also follow these wishes in Northern Ireland. To make sure they follow these, it's important that the advance decision or directive is recorded in writing and includes certain information. For more information and a template advance decision form see factsheet 463, Advance decisions and advance statements, or if you are in Northern Ireland see factsheet NI467, Financial and legal tips.

Recording other wishes

The person may have other important wishes. For instance, a trans person may have wishes about:

  • the clothes they like to wear
  • the pronoun they would like people to use when referring to them
  • any prosthetics (such as an artificial penis).

It is 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. This could include things like the clothes they like to wear, or the things they enjoy doing.

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

For more information and a template advance statement to use as a starting point see booklet 1510, Planning ahead (in England and Wales). If you are in Northern Ireland see factsheet NI467, Financial and legal tips.

Gender recognition certificate

A trans person 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.

For more information search 'gender recognition certificate' on the GOV.UK website.