We explain, in plain terms, what a Health & Welfare Lasting LPA does and why timing matters for families across the UK.
This document lets you appoint someone trusted to make care and treatment choices if you lose capacity. Relatives do not gain automatic legal rights unless they have been formally appointed.
You must register the LPA with the Office of the Public Guardian before it can be used. That makes it valid and easy for doctors, care homes and advisers to rely on the appointed person.
Key point: you can only create an LPA while you still have capacity. Leaving it late can remove your choice and create stress for your family.
Key Takeaways
- An LPA lets a trusted person make future care and treatment decisions on your behalf.
- Relatives do not have automatic decision rights without formal appointment.
- Registration with the Office of the Public Guardian is required before use.
- Create the document while capacity remains; otherwise your options are limited.
- It reduces stress for family during hospital or care home discussions.
What a Health and Welfare Lasting Power of Attorney actually does
An appointed person can take responsibility for daily care and clinical decisions if you lose the ability to decide.
In simple terms, a lasting power gives your chosen person authority over everyday living choices. This includes where you live, the level of home support versus a care home, and routines such as meals and personal care.
Decisions it can cover
The document covers lifestyle decisions like daily routine, diet, personal preferences and who you see. It helps avoid arguments about care and keeps your wishes central.
Medical care and treatment
Your attorney can speak with clinicians, ask questions and weigh treatment options on your behalf. They work with medical teams and must follow what is clinically appropriate and in your best interests.
When it can be used
This authority only starts if you lack mental capacity. You retain control while you can make decisions. Think of the lasting power as a spare key you hope you never need.
Want more detail? Read our short guide for a clear walkthrough: lasting power explained.
Why timing matters: when to make a health and welfare power of attorney uk
Acting while you can locks in who speaks for you if you lose the ability to decide.
Mental capacity is about understanding, weighing options and communicating a choice. The law demands that you have that ability when you sign. If you still have capacity, you can choose who will act on your behalf later.
If capacity is lost and no document exists, clinicians and care teams will decide using a best interests approach. Family will be consulted. They will not have the legal final say.
Common triggers that prompt people
- Retirement or reaching milestone ages such as 60–70.
- Early signs of dementia or memory decline.
- A serious diagnosis that could affect thinking.
- Simply wanting peace of mind for the future.
| Trigger | Why act now | What changes if delayed |
|---|---|---|
| Age milestone | Planning time to choose trusted people | May lose chance to appoint preferred decision-maker |
| Early dementia signs | Preserves personal wishes and daily routines | Decisions shift to clinicians using best interests |
| Serious diagnosis | Ensures medical preferences are followed | Family can be involved but not decisive |
The difference between Health & Welfare and Property & Financial Affairs LPAs
Two separate documents protect very different parts of your future: one covers money and property, the other covers personal care and treatment.
Property & financial affairs deals with accounts, bills, benefits and your bricks and mortar. An attorney property can pay household bills, manage bank accounts, claim benefits and, if needed, sell property.
Why people often choose both
Illness or a move into care usually brings money decisions alongside routine care. That is why many homeowners take out both types. It keeps care choices and financial chores aligned.
When each document can start
Financial LPAs can be used once registered. They can even operate while the donor still has capacity if the form allows it.
Welfare LPAs only begin if the donor lacks capacity. Both forms must be registered with the Office of the Public Guardian before they are valid.
“One tool protects your lifestyle and care; the other keeps household finances running smoothly.”
Early warning signs it’s time to put an LPA in place
We recommend acting early when small changes start to affect daily choices. Spotting signs gives families breathing space and clearer options later.
Conditions that affect capacity
Illnesses that may prevent decision-making include dementia, brain injury, severe mental health episodes, alcohol or drug misuse, and side-effects from treatment.
For example, strong pain relief or chemotherapy can impair judgement in short bursts. Capacity can vary day by day. That is why early planning matters.
Planning for care home decisions before crisis
Pressure often rises at hospital discharge or when home support is no longer safe. Safeguarding concerns can force rapid choices about a care home placement.
Having paperwork in place reduces confusion. It helps staff, clinicians and families agree quickly about next steps.
Preparing for accidents or sudden illness
Think through an unexpected fall or stroke. An emergency can leave someone else needing to speak confidently with doctors and care teams.
- Spot repeated memory lapses or poor judgement.
- Note mood shifts that affect daily living.
- Record short-term capacity changes from treatment side-effects.
Quote: “Putting arrangements in place early is often the calmest, kindest step a family can take.”
Make sure the paperwork matches your plan so your family can act without legal roadblocks. We can help explain the options and next steps.
Mental capacity and decision-making in the UK
Capacity means being able to grasp, weigh and explain a choice. That simple test guides whether someone can lawfully make decisions for themselves.
What capacity looks like day to day
We judge capacity by four practical steps: understanding information, remembering it long enough, weighing options and communicating a choice.
This is not about intelligence. It is about those four skills for a specific decision at that time.
Capacity can vary by decision
Someone might easily choose a meal yet be unable to sign a complex care contract. Capacity is decision‑specific.
It also fluctuates. Infections, medicines or mood can change what someone is able make decisions about on any given day.
Who assesses capacity and what evidence is used
Healthcare professionals usually carry out assessments. They record findings, reasoning and the exact decision reviewed.
- Who: nurses, GPs or consultants involved in care.
- What: notes on understanding, memory and communication.
- Why it matters: a welfare LPA only “switches on” when someone lacks capacity for that decision.
“Assessments protect rights. They are about making lawful, supportive choices — not taking control away.”
For more on ensuring documents match capacity checks, see ensure your LPA covers mental capacity.
Choosing your attorney or attorneys: getting the people and the setup right
Choosing who will speak for you later is one of the most practical gifts you can leave your family. We guide you through the choices and the simple steps that reduce stress.
Who can act and what to look for
An attorney can be any adult aged 18 or over. That includes a spouse, grown child, close friend or a paid professional.
Look for: trust, availability, calm under pressure and a willingness to speak up with clinicians.
Family, friends or a professional
Many choose family or friends for closeness. Others prefer a solicitor for neutrality.
Typical solicitor costs start from about £500 and can be higher for extra work.
Joint versus joint and several
You can appoint several attorneys. Choose joint if you want them to act together.
Choose joint and several if you want flexibility when one person is unavailable. For example, if one attorney is abroad, the other can act alone.
| Option | How it works | Practical benefit |
|---|---|---|
| Single attorney | One person makes decisions | Clear lines of responsibility |
| Joint attorneys | Must agree and act together | Shared oversight, but can cause delays |
| Joint and several | Can act together or independently | Flexible when urgent decisions are needed |
Talking it through
We encourage an honest chat now so your attorneys know your wishes.
- Ask: “What matters most to me day by day?”
- Ask: “What would I find unacceptable?”
- Explain any religious or routine preferences.
“Choosing well and talking clearly saves families time and heartache.”
What decisions your attorney can make about treatment and care
When someone cannot express preferences, an appointed person helps turn wishes into clear choices about daily care and clinical options. We support families through this process so the focus stays on comfort and respect.
Consent and refusal: how attorneys support medical treatment decisions
An attorney can give consent for, or refuse, treatment on the donor’s behalf when capacity is lost. They should follow any written wishes and known values, and always act in the donor’s best interests.
Practical point: this covers routine care choices and complex medical treatment discussions. The attorney asks questions, weighs risks and benefits, and records why a decision was reached.
Access to health records and working with care teams
Attorneys have a right to relevant records so they can make informed choices. That access helps them speak confidently with GPs, specialists and care staff.
Good communication means asking for explanations, clarifying likely outcomes and ensuring the donor’s voice guides the care plan.
Limits to an attorney’s powers
An attorney cannot force clinicians to provide treatment that is not medically appropriate. For example, they cannot insist on CPR if doctors judge it futile.
If professionals disagree with an attorney, teams hold best interests meetings. Evidence such as written wishes, advance statements or notes from family strengthens the attorney’s position.
Life-sustaining treatment: the choice you must make in the form
One choice on the form asks whether your chosen person may authorise treatment that keeps you alive in critical moments. This is a clear, weighty decision. It affects how clinicians act if life‑preserving options arise.
What life-sustaining treatment can include
Life‑sustaining treatment covers interventions like cardiopulmonary resuscitation (CPR) and artificial ventilation. It can also include dialysis or other intensive support aimed at prolonging life.
What the form actually asks
The form asks whether you want to give your representative the power to decide about such interventions. Tick yes if you trust them to weigh options under pressure. Tick no if you prefer clinicians to decide.
What happens if you do not give this authority
If you withhold this power, the doctor in charge will decide on life‑sustaining steps. They will act using the best interests test and clinical guidance. Family views are considered, but clinicians make the final call.
- Who do I trust under pressure?
- How would I define an acceptable quality of life?
- Do I have an advance decision that already covers this?
| Choice on form | Practical effect | When it matters |
|---|---|---|
| Grant authority | Your representative can agree or refuse life‑preserving treatment on your behalf | Serious illness, sudden collapse, admission to intensive care |
| Withhold authority | Clinician decides using best interests; family consulted but not decisive | When rapid medical decisions are needed and no clear advance directive exists |
| Combine with advance decision | Your written refusal of specific treatment stands; representative follows that refusal | When you have clear preferences about particular treatments |
“Talk this through calmly now. Surprises in hospital are hard for families and staff alike.”
How to make and register a lasting power with the Office of the Public Guardian
Start by confirming you are over 18 and that you can understand and sign the form today. This single check is essential for the process to be valid.
Eligibility and completing the form
Eligibility: anyone aged 18 or older who has mental capacity at signing may create this document.
Most people in England and Wales use the government form on GOV.UK. It guides you step by step and often removes the need for a solicitor.
Registering with the Office of the Public Guardian
Your lasting power cannot be used until it is registered with the Office of the Public Guardian. Registration makes the document legally effective.
Typical timescales are around 8–10 weeks when there are no errors. Delays, omissions or high demand can extend this to around 20 weeks.
Common mistakes that delay registration
- Missing signatures or incorrect signing order.
- Uncompleted sections or absent witness details.
- Conflicting dates or unclear information about attorneys.
After registration: tell relevant people
Once registered, tell your GP, close family and any care providers. Share where the registered document is stored and how to contact the attorney.
| Action | Why it matters | Quick tip |
|---|---|---|
| Register with public guardian | Document becomes usable | Apply online via GOV.UK for speed |
| Inform GP | Helps clinical teams recognise the attorney | Give clinic a copy or reference number |
| Store details accessibly | Family can find the paperwork in emergencies | Keep with will and key contacts |
“Register promptly and share details widely — it keeps decisions clear and families calm.”
Costs, reductions, and realistic timeframes for putting an LPA in place
Planning costs and waiting times early helps avoid stress later. We set out the real fees, likely delays, and the options if matters become urgent.
Registration fees and help with costs
In England and Wales the registration fee is £92 per LPA. If you register both documents you pay two fees.
Reductions or exemptions may apply for people on low income or certain benefits. Check eligibility with the office public guardian before you apply.
Budgeting: DIY versus solicitor support
You do not need a solicitor. Many complete the form themselves online.
Solicitors commonly charge around £500+. That cost covers advice, form checks and an extra layer of quality control.
Realistic timelines and urgent requests
Registration typically takes eight to ten weeks if forms are correct. Errors can extend this period.
If you face time pressure, contact the public guardian and explain the situation. They may prioritise or advise next steps.
| Item | Typical cost | Notes |
|---|---|---|
| Registration (each LPA) | £92 | Two documents = two fees |
| Solicitor help | £500+ | Includes checks and guidance |
| Registration time | 8–10 weeks | Longer if mistakes occur |
If no document exists and capacity is lost, you may need to apply court protection routes such as deputyship through the Court of Protection. For practical guidance see our brief guide on how registering with the Office of the Public.
“Planning ahead saves money, time, and worry when families need clarity most.”
If you don’t have an LPA: who makes decisions and what your family can do
Families often find that, lacking paperwork, decisions rest with treating staff who follow best-interests rules.
What happens in practice: clinicians and social care professionals lead on care and affairs when capacity is gone. They consult relatives, but the final call rests with those professionals, guided by legal best-interests tests.
Applying for longer-term authority
If ongoing control is needed, you can apply court protection by asking the Court of Protection for deputyship. This gives someone formal legal authority over property and affairs.
Expect delays and costs. Deputyship can take months and involves fees, reports and supervision. That is why planning earlier often saves stress and money.
Short-term financial workarounds
- Bank third party mandates let someone manage payments while banks check identity and safeguards.
- Benefit appointees handle welfare benefits where needed.
- These options are limited and usually cover only immediate finances, not wider decisions.
Check whether a document already exists
Before applying court protection, check the register. Submit form OPG100 via GOV.UK to the Office Public Guardian to confirm whether a lasting instrument or an enduring power exists.
| Situation | Practical step | How long |
|---|---|---|
| No document and urgent need | Use bank mandate or appointee; consult clinicians | Days–weeks |
| No document and ongoing control needed | Apply Court of Protection for deputyship | Months |
| Uncertain older document | Check register (OPG100) for enduring power or registered instrument | Weeks |
“Act early where possible. It keeps family conflicts low and gives someone clear legal authority.”
Conclusion
Acting while you can ensures decisions reflect your wishes, not guesses.
Put simply: an LPA lets you name trusted people to speak for you if capacity is lost. Register the form, then tell your GP, close family and any care provider where the document lives.
What you gain: clear direction about who speaks, less uncertainty for relatives, and smoother discussions with clinical teams and at a care home.
Practical next steps: choose your representative, complete and register the form, and share the details. For further guidance see our welfare power guide.
Final thought: putting the paperwork in place is one of the most caring acts you can take. It removes guesswork in hard moments and protects those you love.