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What a Health and Welfare LPA is
A Health and Welfare Lasting Power of Attorney (LPA) lets you choose one or more attorneys to make decisions about your personal welfare if you lose the mental capacity to decide for yourself. It is a legal document under the Mental Capacity Act 2005.
This type of LPA only applies once it has been registered with the Office of the Public Guardian and the donor no longer has capacity to make the relevant decision. Until then, the donor normally makes their own health and care decisions.
Decisions an attorney can make
An attorney can make decisions about day-to-day care, such as where you should live and what kind of support you need. They may also help decide about personal care, including washing, dressing, and diet.
They can speak to doctors, care providers, and social workers on your behalf. This can help ensure your wishes are considered when professionals are planning treatment or care.
If the LPA gives them this authority, attorneys can also consent to or refuse life-sustaining treatment. This is a serious power and must be clearly set out in the LPA form.
Limits on an attorney’s powers
An attorney cannot make decisions that the law does not allow them to make. For example, they cannot vote on your behalf, make a will, or demand treatment that doctors do not consider appropriate.
They must always act in your best interests. They should take account of your past and present wishes, beliefs, values, and any guidance you have left in the LPA.
If you still have capacity to make a decision, your attorney cannot override you. Your own decision comes first while you are able to make it.
How attorneys should act
An attorney must follow the principles of the Mental Capacity Act. They should support you to make your own choices wherever possible and use the least restrictive option available.
They should also keep accurate records and avoid conflicts of interest. If there is more than one attorney, they must follow the way they were appointed, whether jointly or jointly and severally.
Why the wording matters
The powers in a Health and Welfare LPA depend heavily on how the form is completed. A person can choose to give attorneys power over life-sustaining treatment, or leave that power out.
Because the document is so important, it is wise to think carefully about what decisions you want your attorneys to handle. Clear instructions and preferences can help your attorneys act in the way you would want.
Frequently Asked Questions
Health and Welfare LPA attorney powers are the legal powers given to an attorney under a Lasting Power of Attorney for Health and Welfare to make decisions about a donor's personal welfare, care, medical treatment, daily routine, and living arrangements, but only when the LPA is valid and the donor lacks capacity to make the relevant decision themselves, unless the LPA specifically authorizes earlier use for certain decisions.
A person can usually be appointed to hold Health and Welfare LPA attorney powers if they are over 18 and suitable to act in the donor's best interests. Often people choose a trusted family member, friend, or professional, provided the appointment meets the legal requirements for making the LPA.
Health and Welfare LPA attorney powers can generally be used only when the donor no longer has capacity to make the specific health or welfare decision in question. Some decisions may need the attorney to wait until the LPA is registered and the donor has lost capacity, while day-to-day support decisions may still involve the donor as far as possible.
Health and Welfare LPA attorney powers can cover decisions about medical treatment, care arrangements, where the donor lives, day-to-day routine, diet, hygiene, and social activities. They can also include decisions about life-sustaining treatment if the LPA expressly gives that power.
Yes, Health and Welfare LPA attorney powers can include decisions about life-sustaining treatment only if the LPA document specifically says the attorney has that authority. If it does not, the attorney cannot make those decisions.
Health and Welfare LPA attorney powers may allow an attorney to consent to or refuse medical treatment on the donor's behalf if the donor lacks capacity and the attorney has authority over that decision. The attorney must always act in the donor's best interests and follow any valid instructions in the LPA.
Yes, Health and Welfare LPA attorney powers can let the attorney decide where the donor should live if the donor lacks capacity to make that decision. The attorney must choose the least restrictive and most appropriate option in the donor's best interests.
Usually no, Health and Welfare LPA attorney powers are only used when the donor lacks capacity for the specific decision. The donor should make their own decisions whenever they have the mental capacity to do so, and the attorney must support that whenever possible.
Health and Welfare LPA attorney powers deal with personal welfare, care, and treatment decisions, while Property and Financial LPA powers deal with money, bills, property, and financial matters. They are separate types of authority and can be granted independently or together.
Health and Welfare LPA attorney powers do not give the attorney free rein to ignore the donor's wishes. The attorney must consider the donor's past and present wishes, feelings, values, and beliefs, and act in the donor's best interests unless the donor has given a lawful and clear instruction that changes that position.
Yes, Health and Welfare LPA attorney powers can allow the attorney to make decisions about social care arrangements, including care packages, home care, day services, and placement in a care home, if the donor lacks capacity for those decisions.
Yes, Health and Welfare LPA attorney powers can be given to more than one attorney. The donor can choose whether they must act jointly, jointly and severally, or in a combination of ways, depending on how the LPA is set up.
Health and Welfare LPA attorney powers come with duties to act in the donor's best interests, encourage participation where possible, keep proper records, avoid conflicts of interest, and respect the donor's rights, wishes, and dignity. The attorney must also follow the Mental Capacity Act principles.
Yes, Health and Welfare LPA attorney powers can be challenged if there is concern that the attorney is not acting properly, is abusing their position, or is not following the donor's wishes or best interests. The Court of Protection and other safeguarding processes may be involved where necessary.
Health and Welfare LPA attorney powers may affect decisions about the donor's social contacts and day-to-day welfare, but attorneys should not unreasonably restrict contact with family and friends. Any restrictions must be justified, necessary, and in the donor's best interests.
Yes, Health and Welfare LPA attorney powers can cover end-of-life care decisions if the donor lacks capacity and the attorney has authority over health decisions. The attorney must consider any advance decisions, the donor's wishes, and medical advice, and act in the donor's best interests.
If there is a valid and applicable advance decision to refuse treatment, it generally takes priority over Health and Welfare LPA attorney powers for that treatment. The attorney must respect the advance decision unless there is a legal reason it does not apply.
Health and Welfare LPA attorney powers are created when the LPA is properly completed and then registered with the Office of the Public Guardian before they can be used. In most cases they are activated for decisions only when the donor lacks capacity, unless the document states otherwise for specific authority.
Yes, Health and Welfare LPA attorney powers can be revoked by the donor while they still have mental capacity, or they can end if the donor dies or if the LPA is otherwise legally cancelled. An attorney can also disclaim the role if they no longer wish to act.
Before granting Health and Welfare LPA attorney powers, someone should consider whether the chosen attorney is trustworthy, understands the donor's wishes, can make difficult decisions, and will act fairly and responsibly. It is also important to think carefully about whether any specific instructions or preferences should be included in the LPA.
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