LP10 Getting started as an attorney: health and welfare (web version)
Updated 6 August 2024
Applies to England and Wales
1. How to be an attorney
You鈥檝e been appointed as an attorney under a lasting power of attorney (LPA).
The person who made the LPA (the 鈥榙onor鈥�) trusts you to make decisions for them if they lose mental capacity.
鈥楳ental capacity鈥� is the ability to make a specific decision at the time that it needs to be made.
The LPA covers health and care decisions such as:
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where the donor lives
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their day-to-day routine
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personal care
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medical treatments
The law says you must always act honestly and in the donor鈥檚 best interests.
2. What to do now
Talk to the donor about their likes and dislikes, for example:
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any special diet (such as vegetarian)
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where they want to live
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what will happen if they can鈥檛 care for their pets
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how they like to dress and wear their hair
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hobbies and tastes in music, TV, radio or books
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if they prefer being indoors or outdoors
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small things that cheer them up, such as a favourite film, a crossword, a glass of wine or a walk
The more you know, the better you鈥檒l be able to decide on their behalf, if ever the donor can鈥檛.
Ask the donor if they鈥檝e made care plans:
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an to refuse specific treatments (sometimes called a 鈥榣iving will鈥�) that health and social care staff can follow
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a statement of wishes and preferences about their care and treatment (this might be written or told to people)
Check if the donor chose you in the LPA to refuse or consent to treatment to keep them alive. If it鈥檚 you, and they lose capacity:
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you can talk to doctors as though you were the donor
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the LPA may replace any advance decision to refuse a life-sustaining treatment
Find out the donor鈥檚 views on life-saving and other health and social care, including any restrictions or guidance in their LPA.
Ask the donor:
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for contact details (for example, their GP, dentist, optician)
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where they keep the LPA document
Get certified copies of the LPA document
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If they have mental capacity, the donor can certify copies.
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A solicitor or notary will make them for a fee.
3. Helping the donor
As an attorney, you must help the donor to reach their own decisions, if they can.
You can鈥檛 decide for the donor just because you think their decisions are odd or unwise.
The law says that you must assume that someone can make decisions, unless it鈥檚 shown that they can鈥檛.
Help the donor to make decisions
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Check: can they make some decisions?
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Explain in different ways. Would using pictures, sign language or their native language help?
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If there are times when the donor cannot decide and the decision鈥檚 not urgent, wait.
A lack of mental capacity is when a mind or brain problem stops a person making a specific decision when they need to.
If the donor doesn鈥檛 have mental capacity:
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follow any LPA restrictions or conditions
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try to follow guidance in the LPA
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ask others what the donor would do
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don鈥檛 make assumptions based on the donor鈥檚 age, behaviour, condition or appearance 鈥� think about what they as an individual would want
Avoid decisions that restrict the donor鈥檚 freedom
Look for an option with less of an impact.
Make decisions in the donor鈥檚 best interests
Each decision must be the best choice for the donor, not just one that suits other people.
4. Keep records
If you make an important decision for the donor, make a note of it and why it was in their best interests. Write down decisions such as moving the donor to another home, choosing care services or refusing medical treatment.
5. Informing others
Let people know they must contact you, if the donor can鈥檛 make decisions. Tell:
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carers, friends and family
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the donor鈥檚 GP and other healthcare staff
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care workers, the donor鈥檚 social worker and other social care staff
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care home staff, sheltered housing wardens or other housing workers
Staff may want to see proof of your identity and the original LPA or a certified copy 鈥� not a photocopy.
Describe the donor鈥檚 choices
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Tell health and social care staff the donor鈥檚 views on care and medical treatment.
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Give the GP and health and social care staff copies of any advance decision or written statement of wishes and preferences.
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Let care home workers, home helps and hospital staff know about the donor鈥檚 likes and dislikes.
6. Other attorneys
If there are other attorneys, the LPA will say how you act together:
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jointly and severally 鈥� you can decide with other attorneys or by yourself
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jointly 鈥� all attorneys must agree every decision
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jointly for some decisions and jointly and severally for others 鈥� you must agree decisions that are set out in the LPA with all the attorneys. You can make others alone
If you have to make a decision jointly and you don鈥檛 all agree, it can鈥檛 be made.
Can鈥檛 agree?
If you and other attorneys can鈥檛 agree, ask family and friends what the donor would want and what鈥檚 in their best interests.
Use advocacy or mediation. Look online or ask at a library. If the donor is in a home or gets social care, ask staff for help.
You can contact OPG and we may be able to advise, or you may need to apply to the Court of Protection. This could cost 拢385 or more.
6.1 Before you act
THINK 鈥� is this what the donor would want?
CHECK 鈥� can the donor be helped to make all or part of the decision?
REMEMBER 鈥� every decision must be in the donor鈥檚 best interests.
7. Advice
(NHS Wales)
(disability charity)
8. More information
How to be a health and welfare attorney (LP15)
Mental Capacity Act 2005 Code of Practice
The Code of Practice explains attorneys鈥� duties
188体育
Court of Protection
Department for Communities and Local Government
Department of Health
www.gov.uk
9. How to contact us
Get advice, raise concerns or tell us if the donor鈥檚 or your circumstances change (for example, if you move house).
TELEPHONE
0300 456 0300
Monday to Friday 9am to 5pm
Wednesday 10am to 5pm
TEXTPHONE
0115 934 2778