When a parent or loved one begins to need care, one of the most important and most overlooked steps is making sure the right legal authority is in place to support decision-making. A Lasting Power of Attorney is not just paperwork. It is the mechanism that allows a trusted person to act on someone else's behalf when they no longer can.
What Is a Lasting Power of Attorney?
A Lasting Power of Attorney (LPA) is a legal document that allows you (the 'donor') to appoint one or more people (known as 'attorneys') to make decisions on your behalf if you lose the mental capacity to do so yourself.
It is one of the most important documents a person can put in place, yet many families only discover its significance after a health crisis, at which point it may be too late to create one.
"When families contact us about a placement, one of the first things we ask about is LPA. More often than not, there isn't one in place. In some cases that has meant a family member could not formally agree to the admission, which added stress at an already difficult time." — Abafields
An LPA must be created and registered while the person still has mental capacity. Once capacity is lost, it is no longer possible to create one.
What Are the Two Types of LPA?
There are two distinct LPAs in England and Wales, and they cover different areas of life.
Health and Welfare LPA Covers medical treatment, care arrangements, daily routine, living situation, and (if specified) life-sustaining treatment decisions. This type can only be used once the donor has lost mental capacity.
Property and Financial Affairs LPA Covers managing bank accounts, paying bills, collecting pensions, and buying or selling property. This LPA can be used as soon as it is registered, even while the donor still has capacity, with their permission.
Most people creating an LPA for care planning purposes will want both. The health and welfare LPA is the one most directly relevant to care home decisions, medical treatment choices, and daily care arrangements.
Why Does the Health and Welfare LPA Matter in a Care Context?
When a person moves into a care home or requires significant medical intervention, care providers and healthcare professionals will need to know who has the legal authority to make or contribute to decisions on their behalf.
Without a health and welfare LPA in place, no family member, not even a spouse, has an automatic legal right to make care decisions for another adult. This is a common misconception that causes real problems for families.
With a registered health and welfare LPA, the named attorney can make decisions about:
- Where the person lives, including whether they move into a care home
- Day-to-day care preferences and routines
- Medical treatment decisions, including whether to consent to or refuse treatment
- Life-sustaining treatment, if this power has been explicitly granted in the document
The attorney must always act in the donor's best interests and follow the principles set out in the Mental Capacity Act 2005. They are not free to substitute their own preferences; they must reflect what the person would have wanted.
How Is an LPA Created and Registered?
The process involves several steps:
- Choose your attorney or attorneys. These should be people you trust. They do not need legal training. Common choices include a spouse, adult child, or close friend. You can appoint more than one.
- Complete the LPA forms. Forms are available free from the Office of the Public Guardian (OPG) on GOV.UK. There is also an online route via the GOV.UK digital service.
- Have the document witnessed and certified. A certificate provider, someone who has known you personally for at least two years or a professional such as a solicitor or GP, must sign to confirm you understand what you are signing and are doing so voluntarily.
- Register with the OPG. The LPA has no legal effect until it is registered. Registration currently costs £92 per LPA (as of November 2025). Most people creating both types will pay £184 in total. Registration takes approximately 8 to 15 weeks.
A solicitor is not required, but many families choose to use one to avoid errors that could invalidate the document. Age UK's Powers of Attorney guide is a free and thorough resource for families navigating this independently.
What If No LPA Is in Place When Capacity Is Lost?
If a person loses mental capacity without a registered LPA, any family member who needs to manage their affairs must apply to the Court of Protection to become a deputy. This process is significantly more complex, more expensive, and takes considerably longer than registering an LPA in advance.
Deputyship applications can take many months and involve ongoing reporting requirements to the OPG. In the meantime, families may be unable to access funds, agree to care arrangements, or make time-sensitive decisions.
This situation is avoidable. Creating an LPA while capacity is intact takes a matter of weeks and provides lasting security for everyone involved.
Can an Attorney Choose a Care Home?
Yes. Under a health and welfare LPA, a named attorney has the authority to decide where the donor lives, including agreeing to a move into residential care, provided the attorney believes this is in the donor's best interests.
In practice, this means an attorney can visit care homes, review care plans, sign admission agreements, and liaise with the care home on the donor's behalf. Care homes will typically ask to see a certified copy of the registered LPA before proceeding.
If you are in the process of arranging care for a loved one and hold a health and welfare LPA, you can contact Abafields to discuss care options and arrange a visit to our care homes in Bolton.
What Is the Difference Between an LPA and an Advance Decision?
These are two separate legal tools that can complement each other.
An LPA appoints a named person to make decisions. The attorney makes real-time decisions based on what they believe the donor would want.
An Advance Decision to Refuse Treatment (sometimes called a living will) is a written statement made by the person themselves while they have capacity, specifying treatments they would refuse in future circumstances. Attorneys cannot override a valid advance decision.
Where both exist, the advance decision takes precedence for any treatment it specifically addresses. For care decisions not covered by the advance decision, the attorney acts.
How Does LPA Relate to Dementia Care Planning?
Dementia is one of the most common reasons families encounter the LPA question. A dementia diagnosis does not automatically mean the person lacks capacity. Early and mid-stage dementia does not necessarily prevent someone from understanding and signing an LPA.
Acting early after a diagnosis is critical. Waiting until the condition has progressed may mean the window for creating a valid LPA closes.
Over one million people in the UK are projected to be living with dementia by 2025. Planning ahead is not pessimism; it is care.
If a loved one has received a dementia diagnosis and you are thinking about future care arrangements, our residential care team at Abafields can talk through what to expect and how to plan.
Useful Resources
- GOV.UK: Make, Register or End a Lasting Power of Attorney
- Age UK: Powers of Attorney Information Guide (PDF)
- Mind: Lasting Power of Attorney and the Mental Capacity Act
- NHS: Lasting Power of Attorney Explained
Frequently Asked Questions
Can I create an LPA for a parent who has already been diagnosed with dementia?
Possibly, yes. A dementia diagnosis does not automatically mean capacity is absent. A GP or solicitor can assess whether the person understands what they are signing. If capacity is confirmed, the LPA can proceed. Acting quickly after a diagnosis is strongly advised.
Does a care home need to see the original LPA?
No. Care homes and other organisations accept certified copies. A certified copy is one where each page has been signed and dated by the attorney confirming it is an accurate copy of the original registered document.
What happens if the named attorney is no longer able to act?
You can appoint replacement attorneys when the LPA is created. If no replacement was named and the sole attorney can no longer act, it may be necessary to apply to the Court of Protection. This is another reason to name more than one attorney where possible.
Can an attorney make all medical decisions?
Attorneys under a health and welfare LPA can consent to or refuse most medical treatment on behalf of the donor once capacity has been lost. The exception is that they cannot refuse basic nursing care. Life-sustaining treatment decisions only fall within the attorney's authority if this has been explicitly granted in the LPA document.
How does an LPA relate to moving into a care home?
A health and welfare attorney has the legal authority to make decisions about where the donor lives, including agreeing to a move into residential care. The attorney will need to provide a certified copy of the registered LPA to the care home as part of the admission process. For more on what admission to Abafields involves, see our step-by-step guide to arranging care.
Is the LPA fee means-tested?
There is a reduced fee available for those on low incomes. The Office of the Public Guardian can confirm eligibility. Full fee exemption may apply where the donor receives certain means-tested benefits.
