Health & Welfare LPA
Understand the Health & Welfare LPA and the important decisions it covers.
Last updated: 1 December 2024
What is a Health and Welfare LPA?
A Health and Welfare LPA gives your chosen attorneys the legal authority to make decisions about your healthcare, medical treatment, and personal welfare if you become unable to make these decisions yourself.
What Decisions Does It Cover?
Your attorneys can make decisions about:
Daily Care
- Your daily routine (when you get up, meals, activities)
- What you wear
- Personal care and hygiene
- Diet and nutrition
Medical Treatment
- Consenting to or refusing medical treatment
- Choosing doctors and hospitals
- Access to medical records
- Decisions about surgery and procedures
- Mental health treatment
Where You Live
- Whether you stay at home or move to a care home
- Which care home you go to
- Living arrangements
Social and Personal Matters
- Who you have contact with
- Social activities and hobbies
- Religious observances
- Cultural preferences
When Can It Be Used?
Unlike a Property and Financial Affairs LPA, a Health and Welfare LPA can only be used after you have lost the capacity to make a particular decision. While you can still make your own decisions, your attorneys cannot override them.
This means:
- Doctors will consult you first whenever possible
- Your attorneys only step in for decisions you cannot make
- Capacity is assessed for each decision individually
- You may have capacity for some decisions but not others
Life-Sustaining Treatment
One of the most important decisions when making a Health and Welfare LPA is whether to give your attorneys authority over life-sustaining treatment.
If You Give This Authority
Your attorneys can:
- Consent to or refuse life-sustaining treatment on your behalf
- Make decisions about artificial nutrition and hydration
- Decide about resuscitation and ventilation
If You Do Not Give This Authority
Doctors will make decisions about life-sustaining treatment in your best interests, consulting with your attorneys and family but making the final decision themselves.
Note: This is a significant decision that deserves careful thought. Discuss it with your chosen attorneys and consider their willingness to make such difficult decisions.
Working with Healthcare Professionals
Your attorneys will work alongside medical professionals:
- Doctors provide medical expertise and recommendations
- Attorneys make the final decision based on your best interests and known wishes
- Healthcare teams will share relevant information with attorneys
- Attorneys should attend care planning meetings where possible
Preferences and Instructions
You can include guidance in your LPA to help your attorneys understand your wishes:
Preferences (Guidance)
- "I would prefer to be cared for at home as long as possible"
- "I want to continue attending church services"
- "I prefer female carers for personal care"
Instructions (Binding)
- "My attorneys must consult my GP before agreeing to any surgery"
- "I must not be moved to a care home outside my local area"
- "I do not wish to receive blood transfusions"
How It Differs from an Advance Decision
An Advance Decision (Living Will) lets you refuse specific treatments in advance. A Health and Welfare LPA is more flexible:
- Attorneys can respond to situations you did not anticipate
- Decisions can be made based on circumstances at the time
- Attorneys can consent to treatment (Advance Decisions can only refuse)
- Attorneys can consider new medical developments
Many people have both an LPA and an Advance Decision for comprehensive coverage.
Choosing the Right Attorney
For a Health and Welfare LPA, consider choosing someone who:
- Knows your values, beliefs, and preferences well
- Can make difficult emotional decisions under pressure
- Will advocate strongly for your wishes
- Lives close enough to be available when needed
- Can work cooperatively with healthcare professionals
Important Protections
- Attorneys must always act in your best interests
- They must consider your past and present wishes
- They cannot override a valid Advance Decision
- They cannot consent to treatment you are actively refusing (if you have capacity)
- Disputes can be referred to the Court of Protection
Why Both LPAs Matter
We strongly recommend having both types of LPA. Without a Health and Welfare LPA, medical professionals will make decisions about your care without input from your chosen representatives. Your family may have no legal right to be involved in these crucial decisions.
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