Decision-making, advance care planning and the Mental Capacity Act 2005

4. Advance care planning

Planning in advance allows people to plan for a time when they might lack capacity to make a decision. This can be very beneficial for people with dementia. It allows them to put their affairs in order and provides reassurance that the right decisions about their care and treatment will be made in the future, even if they lack capacity to make that decision themselves.

The MCA provides for a range of ways people can plan ahead, including making an Advance Decision to Refuse Treatment or Lasting Powers of Attorney for health and finance. People should be encouraged to plan in advance at the earliest possible opportunity, so that things can be put in place before a loss of capacity. There needs to be greater awareness of the different options people have to plan ahead as well as clear, accessible information and support to help people do this. It is also vital that there are robust systems in place for communicating people’s wishes and that professionals are given effective training to understand and recognise the different ways that people can plan in advance.  

It is essential that there are robust safeguards in place to prevent abuse - any cases of suspected abuse must be properly identified and investigated in order to safeguard people who lack capacity. Financial institutions must work alongside organisations like the Office of the Public Guardian to investigate cases of abuse and to ensure that Powers of Attorney are used appropriately.