Future planning

Future planning means planning ahead for a time when you may not be able to make or communicate your own decisions.

Advanced Statements

Sets out your preferences for future care

Power of Attorney

Legally gives power to others to make decisions

Advanced Statements

An Advance Statement sets out your beliefs, values, preferences and wishes about your future care, health and wellbeing. The statement will let people know about your views, in case you can’t make them known for yourself at some time in the future. You can make an Advance Statement verbally, but it’s better to write it down so that the record of your wishes is permanent.

An Advance Statement can include any aspect of your health and care, such as:

What matters to you in your car
How your religious or spiritual beliefs might be reflected in your care
Where you prefer to be cared for
Day to day preferences, for example dietary needs
Activities you like or don’t like
Practical issues like who will look after your pets

An advanced statement doesn’t have to be written a certain way, but it should be clear for someone else to read and it’s best to include:

Address
Date of birth
Full name
Signed and dated

An Advance Statement can only be made or changed by someone who has the mental capacity to make it for themselves.

More information

No, but anyone making decisions about your care must take it into account. The Mental Capacity Act is clear that decision makers must consider “any relevant written statement made by [you] when [you] had capacity”. This means that anyone making a best interests decision for you must use the information in your Advance Statement to help them understand what your wishes, feelings, beliefs and values might be, and what you would have been likely to think was important, if you were able to make the decision yourself.

You can read more about best interests decisions on our MCA page.

Advance Statements can’t be used to force professionals to give specific treatment, or to give care in a particular way.

You can write an Advance Statement yourself, or with help from others. If you like, you can include family, friends or professionals working with you when you write your statement. It’s important that the right people know what your wishes are, and know that you have made an Advance Statement.

You can find some useful resources including a template for making an Advance Statement at How we can help.

Decision makers can only take your Advance Statement into account if they know about it, or can make reasonable efforts to find out about it.

Keep your Advance Statement in a safe place, and share a copy of it with those who support you. This includes anyone close to you who might need to know what your wishes are, and any professionals who might help you, such as your GP.

If you change your Advance Statement, you will need to make sure that you share the new copy of it with those close to you and those helping you, so that they can stay up to date.

Advanced Decisions

An Advance Decision to Refuse Treatment (ADRT) is a decision made now to refuse specific medical treatment in the future. Medical treatment means things like medication, or being put on a ventilator if you can’t breathe on your own. The Decision only applies if you lack mental capacity to give or refuse consent to medical treatment at some time in the future.

You can make an Advance Decision if you currently have the mental capacity to make the decision and are aged 18 or over.

Writing an Advanced Decision

SHOULD include

Any specific type of treatment that is refused.
The circumstances in which that treatment is refused.

COULD include

Reasons for refusing specific treatment.
A statement of wishes and preferences about any other treatments.
Details of anyone that professionals should speak to help them understand your wishes and preferences.

MUST include

(if the ADRT refuses life-sustaining treatment)

be in writing
include a statement which says clearly that the Decision applies even if your life is at risk or will be shortened as a result of refusing treatment.
be signed and dated by you in the presence of a witness.
be signed and dated by the witness.

The consequences of making an Advance Decision can be very serious. Anyone thinking of making one should think very carefully about what it might mean for them and those who care for them, such as family and friends.

More information

If it is valid, and applicable to the situation that arises, an Advance Decision is legally binding. It doesn’t matter whether others agree with what is written in the Advance Decision. If the Decision is valid and applicable, it must be followed, even if others think that the decision in it is not in your best interests.

Being valid and applicable means that the Advance Decision is relevant to the situation or circumstances that have arisen, and to the treatment that you need at the time. For example, if your Advance Decision states that if you have dementia and refuse all life-sustaining treatment, but you don’t actually have dementia, the refusal of life sustaining treatment won’t apply. Similarly, if your Advance Decision refuses a blood transfusion, but a transfusion is not what you need at the time, the refusal won’t apply (it will only apply when or if you need a transfusion). In both these examples, the Advance Decision is not relevant to the circumstances that have have arisen. Advance Decisions are limited by what you put in them, and the situation that occurs.

It is up to medical professionals to decide whether the Advance Decision applies. If a professional decides that it does not apply, they must still take it into account when deciding what treatment is in your best interests.

Advance Decisions can’t:

refuse basic or essential care to keep you comfortable (such as warmth or shelter).
be used to force professionals to give specific treatment.
change the law on euthanasia and assisted suicide (helping someone to end their life is illegal).
generally, refuse treatment for mental health problems if you are sectioned under the Mental Health Act 1983 at the time the treatment is needed (for example you cannot refuse medication if you are sectioned. The exception to the general rule is that you can refuse electroconvulsive shock therapy or ECT, even if you are sectioned at the time the ECT is needed).

Any decision to refuse medical treatment, including an Advance Decision, must be an informed one. This means that you should think carefully about why you want to make an Advance Decision, what you want to achieve by making one, and the benefits and risks of making one.

Although you don’t have to get advice from a medical professional before you make an Advance Decision, it is recommended that you do, for example from your GP or another professional closely involved in your care, such as a specialist. It is even more important to get advice if the Advance Decision refuses life sustaining treatment.

You can find some useful resources including a template for making an Advance Decision at How we can help.

You might also want to think about getting help from a solicitor to make an Advance Decision. A solicitor will charge for this service.

Keep your Advance Decision in a safe place, and share a copy of it with those who support you. This includes anyone close to you who might need to know what decisions you have made, and any professionals who might help you, such as your GP. It is very important that the people who might need to apply your Advance Decision know that it exists.

If you change your Advance Decision, you will need to make sure that you share the new copy of it with those close to you and those helping you, so that they can stay up to date.

Yes, while you have the mental capacity to do so. You should review your Advance Decision and update it if you think that something has changed. It is recommended that you review your Advance Decision at least every two years, or earlier if something important changes.

An Advance Decision will not apply if:

it has been withdrawn whilst you have the mental capacity to withdraw it.
you act in a way that shows that what is in the Advance Decision is no longer what you want. For example, if you converted to a different religion after you made the Advance Decision, and that religion have different view about certain treatments, that might mean you’ve changed your mind.
something has happened which you could not have thought about at the time that you made the Advance Decision. For example, if you got pregnant after you made the Advance Decision, your pregnancy might change how you feel about the future.
after the Advance Decision was made, you gave an attorney the authority (by way of a Lasting Power of Attorney document) to give or refuse consent to the treatment that is covered by the Advance Decision.

If there is a disagreement about whether your Advance Decision is valid and applicable, or for any other reason, and this can’t be resolved, the Court of Protection can make a decision on what should happen.

Lasting Power of Attorney

A Lasting Power of Attorney (LPA) is a legal document that gives power to others to make decisions about your property and finances, or health and welfare, in case at some time in the future, you can’t make them for yourself.

To make an LPA, you must be over 18 and have the mental capacity to make the decision to appoint an attorney. Generally, this means that you must understand what the LPA is and the effect it has.

More information

No. There is no legal definition of ‘next of kin’ although it is generally taken to mean your nearest relative. In health and care, we often ask people to tell us the name and contact details of their ‘next of kin’ so that we know who to speak to in case of emergency. Being identified as a person’s ‘next of kin’ does not come with any rights to make decisions for them.

What’s in a Lasting Power of Attorney?

An LPA sets out who you have appointed to make decisions for you, and in what areas of your life you want them to make decisions. The LPA can set out any preferences, or any restrictions on the way that you want your attorney to act for you. For example, you might have strong ethical views and specify that your property and financial affairs attorney must not invest your money in tobacco products, animal testing, or weapons.

If you appoint a health and welfare attorney, the LPA must say whether or not you give your attorney power to make life sustaining treatment decisions on your behalf. If you choose not to give this power, medical professionals will make these decisions for you, in your best interests, if you can’t make them.

An LPA must be made using a specific form. You must sign the form to confirm that you are giving power to your attorney. Your attorney must sign it to accept the power that you are giving to them. Each of you must sign in front of a witness, who will also sign the LPA.

A certificate provider must also sign the LPA (after you sign it, and before your attorney signs it) to say that

you understand what the LPA is for and the extent of the power that you are giving under it;
you are not being pressured into signing it; and
there is no other reason the LPA should not be made.

Your certificate provider could be a professional such as a solicitor or a doctor, or someone who has known you well for two or more years. There are some people who can’t be your certificate provider, such as one of your attorneys, or someone related to one of your attorneys.

Once the LPA has been signed, it must be sent to the Office of the Public Guardian (OPG) so that they can register it. The OPG charge a fee for registering LPAs. The LPA can’t be used before it is registered. Once your LPA has been registered, you should store it safely, and make sure that your attorney knows where to find it, in case they need it. You might also want to share a copy with relevant organisations, such as your bank, in case it needs to be used.

You can find the LPA forms and read guidance on how to complete then at GOV.UK. You do not need a solicitor to make an LPA, but you might choose to, especially if you think your affairs could be complicated. A solicitor will make a charge for their help.

Think carefully about who to appoint as an attorney. Unless you put any restrictions on the way they can act for you, an attorney will generally have the power to make any decisions for you that you can legally make for yourself. There are some exceptions to this; for example, your attorney cannot write a Will for you, or consent to marriage or a sexual relationship on your behalf.

An attorney must be over 18 years old and should be someone you trust to make decisions for you, if you ever need them to. An attorney will need to be someone who is willing to help you, and who is able to help you. For example, someone who lives abroad might be very willing to be your attorney but it might be practically very difficult for them to help from a long distance away.

Your attorney could be a family member or a friend, or you could decide to appoint a professional attorney such as a solicitor or an accountant. A professional attorney will usually charge a fee for the time that they spend acting for you. Your attorney should be someone who understands what is important to you, and the choices that you might make for yourself if you could.

It is generally recommended that you choose more than one attorney, if you can. You can choose for your attorneys to act together on every decision they make. Or you can choose for your attorneys to act independently, which means that they can make decisions separately from each other. It is usually more practical for your attorneys to be able to make decisions independently / separately.

It it also a good idea to choose a replacement attorney, in case in the future one of your attorneys can’t act for you anymore (for example, because they have died). You can choose a replacement attorney at the same time that you make your lasting power of attorney, so that if anything happens to your original attorney(s), your attorney document can still be used.

An attorney can make decisions for you, in the areas that you have given them authority (permission).

There are two separate types of LPA, which give authority to make different types of decisions:

Health and welfare LPA – this allows your attorney to make decisions about your health and social care. This means making decisions about your day-to-day life, such as where you live and what help you get to live there. It could mean making more serious decisions such as whether you should have life-saving treatment. Your attorney can speak to professionals on your behalf, such as your GP, optician or dentist, and access your medical records if they need to.
Property and financial affairs LPA – this allows your attorney to make decisions about your money and property. This means making decisions about your day-to-day finances such as paying your bills, or making an investment for you such as buying shares in a company. It could mean making more serious decisions such as selling your home. Your attorney can speak to your benefits or pension provider on your behalf, and access your financial records, if they need to.

Your attorney can only act in line with the powers that you that you have given them in the LPA. Your health and welfare attorney can’t make decisions about your property and finances, and your property and financial affairs attorney can’t make decisions about your health and welfare. You can appoint different attorneys to make different types of decision. For example, you might be very confident that your long-term friend can make health and welfare decisions for you, but because you worry that they are not very good with money, choose to appoint someone else to make your property and financial decisions.

A Lasting Power of attorney document must be registered with the Office of the Public Guardian (OPG) before it can be used.

There is an important difference between the health and welfare LPA and financial affairs LPA.

You can choose to allow a property and finance attorney to take action for you even when you have mental capacity. As long as you can make decisions for yourself, you are in control of your property and finances. But choosing to let your property and finance attorneys act for you as soon as the LPA is registered, can give you more flexibility if you need help. For example, if you are unwell and want your attorney to go to your bank and pay some bills, you can ask them to do that for you.

Health and welfare attorneys can only make decisions for you if you lack mental capacity (can’t make the health and welfare decision for yourself).

A person appointed as your Lasting Power of Attorney must follow the Mental Capacity Act 2005. This means each decision they make must be in your best interests. Making a decision in your best interests includes thinking about your past and present wishes and feelings, and consulting with other people who know you, such as relatives, and professionals involved in your care. Sometimes it might mean asking for specialist help, such as from a financial advisor.

The law also says that attorneys must act with care and skill they make decisions for you. They should act honestly, and not use their power for their own benefit or in a way that would cause a conflict between their interests and your own. The Office of the Public Guardian (OPG) gives guidance on how attorneys should act, which you can read at How to be an attorney – GOV.UK.

If you want to cancel your LPA or change your mind about one of your attorneys, you can do this, while you have mental capacity to make the decision. If they can’t make the decision and someone else is worried about the way your attorney is acting for you, they can make a report to the Office of the Public Guardian (the OPG). The OPG has power to investigate an attorney, and to take action to have them removed, if they are are not acting in your best interests.

You can read more about making a Lasting Power of Attorney, cancelling it, or removing an existing attorney at Make, register or end a lasting power of attorney: Overview – GOV.UK.

You can report concerns about how an attorney (or court appointed Deputy) is acting at Report a concern about an attorney, deputy or guardian – GOV.UK.

If there is a dispute about your attorney document, the way your attorney acts for you, or a dispute between attorneys, and this can’t be resolved, the Court of Protection.

These pages are not meant to offer legal advice