Few people making plans for social care should they lose capacity

Alzheimer's Society warns people with dementia are missing out on benefits of making a Lasting Power of Attorney for planning their future care needs, after revealing low take-up rates.


About Lasting Power of Attorneys for welfare

Under the Mental Capacity Act (MCA) 2005, people can appoint others to take decisions on their behalf about their care, should they lose the capacity to do so, by registering a Lasting Power of Attorney for health and welfare.

LPAs must be registered with the Office of the Public Guardian. The person making the appointment (the donor) can specify restrictions on which decisions can be taken on their behalf, and how decisions can be made.

Attorneys can only act if the person loses capacity to make the decision in question. Attorneys must follow the principles of the MCA in making decisions, including that they act in the donor’s best interests.

In doing so, they must consider the donor’s past and present wishes and feelings, beliefs and values, and consult anyone involved in caring for the donor and close relatives with an interest in their welfare.

Source: Mental Capacity Act code of practice, chapter 7


Relatively few people have made arrangements for social care decisions to be made on their behalf should they lose capacity to make them, Alzheimer’s Society has revealed.

It found 106,299 registered a health and welfare Lasting Power of Attorney (LPA), enabling someone else to take decisions on their behalf should they lose capacity to do so, in England and Wales from 1 October 2007 to 30 June 2012.

This compares with 414,811 who registered an LPA to manage their property and finance over the same period. The number of registrations is also small compared with the number of people with dementia – of which there are about 575,000 in England – a group for whom health and welfare LPAs would be particularly beneficial, Alzheimer’s Society said.

The figure, obtained under Freedom of Information from the Office of the Public Guardian, was included in a report last week from the charity on improving end-of-life care for people with dementia, My life until the end – dying well with dementia.

‘Poor understanding’

“This level of uptake suggests that there is poor understanding of what health and welfare LPAs can offer,” the report warned. “This is particularly concerning for people with dementia as it indicates that the available channels for a person’s wishes to be legally represented are not being used.”

It was vital that people with dementia planned for their future care needs, said the report, which was based on interviews with 25 bereaved carers of people with dementia, 10 current dementia carers and three people with the condition.

“Not having care plans in place or a clear idea of what the person with dementia would want can lead to extensive problems as capacity diminishes and decisions have to be made on their behalf,” it said. “Participants commented on this extensively, talking about problems they encountered when advance plans had not been made.”

Professionals ‘unwilling to discuss end-of-life care’

Interviewees also reported that professionals were unwilling to discuss planning for end-of-life care with them. Many said that professionals had encouraged to plan for financial matters but not future care needs.

An Office of the Public Guardian spokesperson said: “The Office of Public Guardian encourages everyone to prepare for a possible lack of mental capacity and consider making a Lasting Power of Attorney (LPA). Applications for LPAs have increased dramatically over the past five years and we have launched a major transformation programme to make the process of registering an LPA simpler, clearer and faster. We continue to work with our partners to raise awareness of mental capacity issues and to make the services we provide as simple and accessible as possible.”

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