Lasting Power Of Attorney

Overview

A Lasting Power of Attorney (LPA) is a legal document used in England and Wales. It lets you choose one or more people you trust to make decisions for you if, one day, you can no longer make them yourself. The person you choose is called your 'attorney' — but they do not have to be a lawyer. They are usually a partner, a relative or a close friend. An LPA only covers decisions you name in the document. There are two types: one for money and property, and one for health and care. An LPA is not an illness and it is not a sign that something is wrong with you. It is a way of planning ahead, in the same spirit as making a will or saving for later life.

Yes. Millions of people in England and Wales have registered an LPA, often in their 50s, 60s or 70s. Many people set one up simply as good planning, long before they need it. Others make one after a health diagnosis, or when a partner or relative becomes unwell.

Anyone aged 18 or over who has the mental capacity to make one can set up an LPA. It matters most for people whose memory or thinking may change over time, people with a long-term neurological condition, people with complex money matters or a business, people who live alone, and parents of a child with a lifelong disability who will need support in adulthood. It also matters for partners and families, because making an LPA can spare them difficult legal steps later.

Symptoms

Common symptoms

• Finding it harder to weigh up choices, or feeling overwhelmed by everyday decisions
• Repeating the same questions, or forgetting recent conversations
• Struggling with bills, post or paperwork that used to feel easy
• Missing appointments, or forgetting to take regular medicines
• Being easily led by others, or finding it hard to say no to pressure
• These are not 'symptoms' of needing an LPA. They are signs that a person may be finding decisions harder, and they are worth discussing with a doctor.

Symptoms in children

• Children under 18 cannot make an LPA, and parents cannot make one for them. If a young person has a lifelong condition that affects their thinking, families can plan ahead so that support is in place when they turn 18.
• Planning early gives a young adult the chance to choose their own attorneys while they can, rather than having decisions made by a court later.

Symptoms in older adults

• Memory and thinking changes become more likely with age, so planning ahead is often more relevant.
• Older adults are more often targeted by scams or financial pressure, which is one reason a money and property LPA can be useful.
• Sudden confusion in an older person is not a normal part of ageing. It can be a sign of infection or another urgent problem and needs medical help quickly.

Causes

Main causes

• An LPA is not caused by anything. It is a choice people make to prepare for a time when they may not be able to decide things themselves.
• People often make one because of a diagnosis that may affect memory or thinking over time, such as dementia, Parkinson's disease, multiple sclerosis or the effects of a stroke or brain injury.
• Some people plan ahead because of a serious mental health condition that can affect decision-making during a flare-up.
• Others make one for practical reasons: an upcoming operation, running a business, living alone, or simply wanting their family to know their wishes.

Risk factors

• Getting older, and any family history of conditions that affect memory or thinking
• A long-term neurological or mental health condition
• Living alone, or being far from close family
• Complex finances, property, or a business to manage
• Being a parent or carer of someone who will need support into adulthood
• Being in a relationship where you want a partner to have a clear say in health and care decisions

When to see a doctor

See a doctor urgently if:

• A sudden change in someone's memory, confusion or behaviour, especially with fever or feeling unwell
• Memory or thinking problems that are getting worse quickly over days or weeks
• You are worried that someone is being pressured, scammed or financially exploited
• You or someone you care for feels unable to cope, or is unsafe at home

Book a routine appointment if:

• You have noticed memory or thinking changes over months and want to talk them through
• You have a long-term condition that may affect your thinking, and want to plan ahead
• You are making an LPA and want to understand what mental capacity means
• You want to discuss your wishes for future care with your doctor

Diagnosis

There is no medical test for an LPA. What doctors are sometimes asked to look at is mental capacity: whether a person can make a particular decision at a particular time. In England and Wales this is guided by the Mental Capacity Act. The starting point is always to assume a person can decide for themselves. A doctor will check whether there is a condition affecting the mind or brain, and if so, whether the person can understand the decision, remember the information long enough to use it, weigh up the options, and communicate their choice. Capacity is decision-specific: someone may be able to decide what to eat but not how to invest money.

Tests that may be done

• A conversation-based assessment, where the doctor explains the decision in plain words and asks the person to say it back and weigh the options
• Memory and thinking questions done in the surgery or at a memory clinic, if a problem is suspected
• Blood tests to look for treatable causes of confusion, such as an infection, a thyroid problem or a vitamin deficiency
• A brain scan, in some cases, if a specialist thinks it will help
• Reports from people who know the person well, with their permission

What to expect at your appointment

A capacity assessment is usually a relaxed conversation, not an exam. The doctor will explain what they are doing and why. If you are setting up an LPA, you do not need a doctor's letter. The LPA has a section where someone confirms you understand what you are signing; this is often done by a professional such as a solicitor or a doctor, but it is not a medical test. If you are ever unsure, ask the person completing that section to explain it to you before you sign.

Treatment

An LPA is a legal arrangement, not a medical treatment. There is nothing to cure. Instead, the focus is on planning well, keeping the document up to date, and looking after the health conditions that can affect memory and thinking so that you stay independent for as long as possible.

Self-care at home

• Choose attorneys you trust completely, and talk to them about it first so they know what you would want
• Think about choosing more than one attorney, and say whether they must decide together or can decide separately
• Write down your wishes and preferences in the document, including anything you feel strongly about
• Register the LPA with the Office of the Public Guardian as soon as it is signed — it cannot be used until it is registered
• Tell your GP, your family and anyone close to you that the LPA exists, and where the original is kept
• Review your LPA every few years, or after a big change such as a separation, a bereavement or a new diagnosis
• Keep the original somewhere safe and tell your attorneys where it is

Medical treatments

There is no medical treatment for an LPA itself. Where memory or thinking is affected, doctors focus on finding and treating any underlying cause, managing long-term conditions, reviewing all medicines to check nothing is adding to confusion, and offering support such as memory services, occupational therapy and help at home. Doctors cannot make decisions for you, and they cannot take away your right to decide. If you ever lose capacity, healthcare staff will still involve you as much as possible and will follow any wishes written in your health and welfare LPA.

When is surgery considered?

If you have a planned operation or a hospital stay coming up, it is worth making or registering an LPA beforehand. Anaesthetic and illness can sometimes cause temporary confusion, and having the paperwork in place makes things easier for the people supporting you. It is also a good moment to tell the hospital team who your attorneys are.

Living with this condition

Most people with an LPA carry on exactly as before. The document sits quietly in a drawer and is only brought out if it is needed. The difference is peace of mind: if something unexpected happens, the people you chose already have the legal authority to step in, and your family does not have to apply to a court while also coping with worry.

Lifestyle tips

• Keep your attorneys updated about your health, money and any changes in your life
• Store the original LPA safely and give certified copies to your attorneys and your GP
• Update your will and your LPA at the same time if your circumstances change
• Stay socially connected — regular contact with others helps you notice changes early and keeps decisions shared
• Keep learning and doing things you enjoy; mental stimulation and routine support day-to-day wellbeing

Diet and exercise

There is no diet or exercise that replaces an LPA, but looking after your general health helps you stay independent for longer. Regular movement you enjoy, a balanced diet, enough sleep, not smoking, keeping alcohol within sensible limits, and having your blood pressure checked are all sensible habits. If you have a long-term condition, taking it seriously and attending reviews gives you the best chance of staying sharp and in charge of your decisions.

Mental health and emotional wellbeing

Thinking about losing the ability to decide for yourself can feel frightening, and it is completely normal to feel sad, anxious or reluctant to start the conversation. Families often find that talking it through openly brings them closer, but it can also stir up old tensions. Be gentle with yourself and with each other, take it at your own pace, and ask for help if it starts to weigh on you. If you ever feel you cannot keep yourself safe, contact your local emergency number or a crisis line in your country straight away, and reach out to a doctor or a trusted person for support.

Prevention

You cannot prevent the need for an LPA — anyone might one day need help with decisions. What you can do is prepare: make and register an LPA while you are able to, choose people you trust, write down your wishes, and tell those people where the document is. Looking after your general health, especially your heart and blood pressure, reduces the risk of some conditions that affect thinking later on.

Vaccines

Staying up to date with the routine vaccinations your local health service offers is sensible for older adults and anyone with a long-term condition. Some infections can cause sudden confusion, so preventing them helps protect your thinking as well as your general health. Ask your GP or pharmacist what you are due.

Screening programmes

There is no screening test for needing an LPA. There is also no routine NHS screening test for dementia; memory concerns are looked at when a person raises them. If you are over 40, you may be invited for an NHS Health Check, which looks at heart and blood pressure risk. If you or someone close to you has noticed changes in memory or thinking, mention it to your GP rather than waiting.

Complications

If left untreated

• If someone loses capacity without an LPA in place, no one can automatically make decisions for them. Family members do not get that right by default.
• In England and Wales, someone may have to apply to the Court of Protection to be appointed a deputy. This can take months, involves fees, and the court decides who it will be.
• Banks and other organisations may freeze accounts until the legal position is clear, which can cause real practical and financial stress.
• Decisions may end up being made by someone the person would not have chosen, or in ways they would not have wanted.
• Families can fall out over who should decide, at a time when they most need to pull together.

Long-term outlook

The outlook is genuinely positive. Making an LPA is a straightforward, well-established step, and most people who make one never need to use it. It gives you a say in advance and gives the people who care about you a clear, calm route to help. If you have not made one yet, it is never too early to start the conversation — and if you have already made one, a quick check that it is registered and that your attorneys still feel like the right choice is all that is needed.

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