How Does Power of Attorney Work When Someone Has Dementia?

When someone you love is living with dementia, planning for the future can feel overwhelming. Understanding how power of attorney works is one of the most important steps you can take to protect their wishes, their wellbeing, and their dignity. We explain what a lasting power of attorney is, the different types available, how to set one up, and what happens if one is not in place.

What Is a Lasting Power of Attorney?

A lasting power of attorney (LPA) is a legal document that allows a person to appoint one or more trusted individuals to make decisions on their behalf. The person appointed is known as an 'attorney' and is legally bound to act in the person's best interests at all times.

Because dementia is progressive, there will likely come a point when the person living with the condition can no longer make certain decisions for themselves. This is referred to as lacking 'mental capacity.' An LPA ensures that when this happens, someone they know and trust is ready to step in, rather than decisions being left to people they may never have met.

What Are the Different Types of LPA?

There are two types of lasting power of attorney in England and Wales. A person can choose to make one or both, and they can appoint the same attorney for each or name different people.

Health and Welfare LPA

This type gives the attorney the power to make decisions about the person's daily care, medical treatment, and living arrangements. This can include choices about daily routines, whether to move into a care home, and decisions around life-sustaining treatment. A health and welfare LPA can only be used once the person has lost the mental capacity to make their own decisions.

Property and Financial Affairs LPA

This type covers decisions about money and property. The attorney can manage bank accounts, pay bills, collect pensions and benefits, and even sell property if needed. Once registered with the Office of the Public Guardian, this LPA can be used straight away with the person's permission, even while they still have capacity. It can also be held in readiness for when it is needed.

It is worth noting that even if someone is married or in a civil partnership, their spouse does not automatically have the right to manage their finances or make decisions about their care. An LPA is the only way to formally grant this authority.

Why Is an LPA So Important for People Living with Dementia?

Most people living with dementia will eventually reach a point where they are unable to make informed decisions. Setting up an LPA while mental capacity remains means the person can choose who they would like to act on their behalf and can express their wishes clearly.

Without an LPA, family members may need to apply to the Court of Protection to be appointed as a 'deputy,' which grants similar powers to those of an attorney. However, this process is often time-consuming, expensive, and stressful during what is already a difficult period.

What Does Mental Capacity Mean?

Mental capacity is a legal term referring to a person's ability to understand, retain, and use information to make a decision, and then communicate that decision. A person is considered to lack mental capacity if they cannot do one or more of these things.

It is important to understand that mental capacity can fluctuate. Someone living with dementia may be able to make straightforward decisions, such as what to have for lunch, but struggle with more complex matters like financial planning. Capacity is also assessed on a decision-by-decision basis, so it is never an all-or-nothing judgement.

The Mental Capacity Act provides the legal framework designed to protect and empower people who may lack mental capacity, ensuring that any decision made on their behalf is always in their best interests.

When Should You Set Up an LPA?

The single most important thing to understand is that an LPA can only be made while the person still has mental capacity. A common misconception is that a dementia diagnosis means a person can no longer create an LPA, but this is not true. Many people retain capacity for some time after diagnosis, and it is strongly recommended to begin the process as early as possible.

It is impossible to predict how quickly dementia will progress, so acting promptly gives the person the best opportunity to have their voice heard and their preferences honoured.

How Do You Set Up an LPA?

Setting up an LPA can be done independently or with the support of a solicitor.

Choosing the Right Attorney

The attorney must be over 18, capable of managing their own affairs, and someone the person trusts. This could be a partner, an adult child, a close friend, or a professional such as a solicitor. If multiple attorneys are appointed, the person must specify which decisions need to be made jointly and which can be made individually.

Completing and Signing the Forms

LPA forms can be completed online, downloaded from GOV.UK, or requested in paper form from the Office of the Public Guardian. The forms must be signed by the person making the LPA, the named attorney or attorneys, a witness, and a certificate provider. The certificate provider confirms that the person understands what they are signing and is not being pressured into making the LPA. They must be someone who has known the person for at least two years, or a relevant professional such as a doctor or solicitor.

Registering the LPA

Once completed, the forms must be sent to the Office of the Public Guardian along with the registration fee, which is currently £92 per LPA. If both types are registered, the total cost is £184, though fee reductions or exemptions may apply depending on the person's circumstances. Registration typically takes eight to ten weeks, provided there are no errors on the form.

Can an LPA Be Changed or Revoked?

If the person still has mental capacity, they can change or revoke their LPA at any time. To remove an attorney, they must send a 'partial deed of revocation' to the Office of the Public Guardian. To end the LPA entirely, they must submit the original document along with a written 'deed of revocation.' If they wish to appoint a new attorney, the existing LPA must be ended and a new one created.

An LPA will also end automatically in certain circumstances, such as if the attorney dies or loses their own mental capacity.

What About Advance Decisions and Advance Statements?

Alongside an LPA, there are additional ways to plan ahead: 

• An advance statement is a written record of a person's preferences, wishes, beliefs, and values regarding their future care. This might include how they would like religious beliefs reflected in their care, where they would prefer to be cared for, or personal routines that matter to them. While not legally binding, an advance statement will be taken into account by attorneys and healthcare professionals.
• An advance decision (sometimes called a 'living will') is a legally binding document in which a person can refuse specific medical treatments in the future, including life-sustaining treatments such as CPR or ventilation. If the advance decision relates to life-sustaining treatment, it must be written down, signed by the person, and witnessed.

What Happens If No LPA Is in Place?

If a person loses mental capacity without having made an LPA, their family cannot automatically step in to manage finances or make care decisions. Instead, they may need to apply to the Court of Protection to become a deputy. This process can be lengthy, costly, and emotionally draining, and the court may appoint someone the person would not have chosen themselves. Setting up an LPA in advance avoids this uncertainty entirely.

How KYN Supports Families Through Every Stage of Dementia Care

At KYN, we understand that navigating the legal and practical aspects of dementia can feel daunting, and that families often carry these concerns alongside the emotional weight of caring for someone they love. Our person-centred approach to dementia care is designed to support not only residents but also the families around them.

Every resident at KYN receives a bespoke care plan shaped by their personality, preferences, and individual needs. Our specially trained care teams provide tailored support in safe, dementia-friendly environments where dignity, independence, and quality of life are always at the heart of what we do. From our life enrichment and wellbeing programme to award-winning dining crafted by Tristan Welch, every detail is considered with care.

We also recognise the importance of keeping families informed and connected. Our dedicated family portal provides peace of mind, while our compassionate teams are always available to offer guidance and reassurance.

If you are exploring care options for someone living with dementia, we warmly invite you to visit one of our homes and experience the KYN difference for yourself. Please get in touch to arrange a private tour or to request a brochure.

For our mothers, for our fathers, for our KYN.