Lasting power of attorney for people with dementia

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?’).

Watch our video to see how making a Lasting power of attorney helped Diana and her husband Eugene, who was living with dementia:

Who can make a Lasting power of attorney?

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 a Lasting power of attorney?

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.

Why should I make a Lasting power of attorney?

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 a Lasting power of attorney?

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 a Lasting power of attorney?

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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