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What a Health and Welfare LPA is
A Health and Welfare Lasting Power of Attorney, often called a Health and Welfare LPA, is a legal document that lets you choose one or more people to make certain decisions for you if you lose mental capacity. It only takes effect when you cannot make those decisions yourself.
This type of LPA is different from a Property and Financial Affairs LPA. It deals with personal welfare matters rather than money or property.
What decisions an attorney can make
An attorney can usually make decisions about your day-to-day care. This may include where you live, what help you receive with washing, dressing, and eating, and what kind of support is needed to keep you safe and well.
They may also decide about medical treatment, including whether to accept or refuse certain treatment on your behalf. However, this only applies where you lack capacity to make the decision yourself at the time.
If the LPA gives them authority, they can also decide whether you should move into a care home or receive treatment in hospital. Their role is to act in your best interests and follow any instructions or preferences you set out.
Limits on an attorney’s powers
An attorney does not have unlimited control. They must always act within the terms of the LPA and follow the Mental Capacity Act 2005.
They cannot make decisions you have not authorised them to make. For example, they cannot override a decision where you still have capacity, and they cannot consent to or refuse life-sustaining treatment unless the LPA specifically allows it.
They also cannot do anything that would go against the principles of best interests or your known wishes, feelings, beliefs, and values. Their decisions must be careful, reasonable, and properly considered.
How life-sustaining treatment works
Life-sustaining treatment is a special category in a Health and Welfare LPA. It covers treatment that is needed to keep you alive, such as certain medical interventions in an emergency or serious illness.
If you want your attorney to be able to make decisions about life-sustaining treatment, this must be clearly stated in the LPA. Without that authority, doctors will usually make the final decision based on the law and clinical judgment.
What the attorney must do
An attorney must always act in your best interests. They should consider your past and present wishes, consult with relevant professionals, and involve family or others where appropriate.
They should keep a clear record of decisions and avoid any conflict of interest. The role is about protecting your welfare, not following their own views.
Frequently Asked Questions
Health and Welfare LPA attorney powers are the authority given to an attorney under a Health and Welfare Lasting Power of Attorney to make decisions about a person’s personal welfare and healthcare, but only when the donor lacks capacity to make those decisions themselves. These powers can cover where the donor lives, day-to-day care, medical treatment, and life-sustaining treatment if the LPA includes that authority.
A donor can appoint one or more adults they trust to exercise Health and Welfare LPA attorney powers, as long as the person is over 18 and has mental capacity to make the appointment. The attorney is usually a family member, friend, or another trusted individual who is willing and able to act in the donor’s best interests.
Health and Welfare LPA attorney powers generally take effect only when the donor no longer has the mental capacity to make the relevant health or welfare decision for themselves. Until that point, the donor remains in control of their own decisions, unless they choose to involve their attorney informally.
Health and Welfare LPA attorney powers can cover decisions about daily routine, diet, care arrangements, social activities, medical treatment, and whether the donor should receive life-sustaining treatment, if that power is expressly included. They can also be used to help choose care homes or supported living options if the donor cannot decide for themselves.
Yes, Health and Welfare LPA attorney powers can include authority to consent to or refuse life-sustaining treatment, but this must be expressly granted in the LPA form. If the donor does not include this authority, the attorney cannot make that specific decision.
No, Health and Welfare LPA attorney powers do not allow an attorney to ignore the donor’s valid and current wishes if the donor still has capacity. Even when the donor lacks capacity, the attorney must act in the donor’s best interests and take account of their past and present wishes, feelings, beliefs, and values.
A person exercising Health and Welfare LPA attorney powers must act honestly, carefully, and in the donor’s best interests. They should support the donor to make decisions where possible, keep relevant records, avoid conflicts of interest, and follow the law and the terms of the LPA.
Yes, Health and Welfare LPA attorney powers can include decisions about where the donor should live if they lack capacity to decide for themselves. This may involve choosing between remaining at home with support, moving into residential care, or other suitable arrangements.
Yes, Health and Welfare LPA attorney powers can be used to consent to or refuse medical treatment on the donor’s behalf when the donor lacks capacity. The attorney must consult medical professionals, consider the donor’s wishes and values, and make decisions in the donor’s best interests.
Yes, Health and Welfare LPA attorney powers can be given to more than one attorney, and the donor can specify whether they must act jointly, jointly and severally, or in a mixture of ways for different decisions. The wording of the LPA is important because it determines how the attorneys may act together.
Health and Welfare LPA attorney powers can sometimes be changed before the LPA is registered, if the donor has capacity and follows the correct legal process. After registration, changes are limited and usually require a formal deed of revocation, severance, or making a new LPA, depending on the circumstances.
Yes, Health and Welfare LPA attorney powers can be revoked by the donor if they still have mental capacity. An attorney can also be removed in some situations, such as resignation, death, bankruptcy in certain cases, misconduct, or a court decision.
If someone uses Health and Welfare LPA attorney powers without proper authority, their decisions may be invalid and they may face legal consequences. Acting outside the scope of the LPA can lead to complaints, investigation by the Office of the Public Guardian, and possible court action.
No, Health and Welfare LPA attorney powers do not include financial decisions. Financial matters require a separate Property and Financial Affairs LPA, because health and welfare authority is limited to personal welfare and medical-related decisions.
Health and Welfare LPA attorney powers should only be used for decisions the donor cannot make at that time. If the donor has capacity for a particular decision, they make that decision themselves, and the attorney should support rather than replace them.
An attorney usually proves Health and Welfare LPA attorney powers by showing the registered LPA document or certified copies of it. Health and care professionals may also check the Office of the Public Guardian registration details if needed.
Before using Health and Welfare LPA attorney powers, an attorney should confirm that the LPA is valid and registered, assess whether the donor lacks capacity for the specific decision, and check whether the decision is within their authority. They should also consult relevant professionals and anyone else the donor would want involved where appropriate.
Yes, Health and Welfare LPA attorney powers can be used for day-to-day care decisions such as meals, washing, dress, routine activities, and care support arrangements when the donor cannot decide for themselves. The attorney must still respect the donor’s preferences and dignity as far as possible.
No, Health and Welfare LPA attorney powers are not the same as being next of kin. Next of kin does not automatically give legal authority to make health or welfare decisions, whereas a registered Health and Welfare LPA does give specific legal powers.
Before granting Health and Welfare LPA attorney powers, someone should choose attorneys they trust, think carefully about whether to include life-sustaining treatment authority, and consider how decisions should be made if more than one attorney is appointed. They should also make sure the document clearly reflects their wishes, values, and preferences.
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