Planning for Tomorrow: Lasting Powers of Attorney and End-of-Life Care

Dying Matters Awareness Week (4th – 10th May), led by Hospice UK, is a national initiative that encourages people to have open conversations about death, dying, and bereavement to break down taboos, reduce stigma, and ensure personal wishes are known and supported.

The Isle of Wight High Sheriff has launched a campaign called ‘My Life. My Death. My Plan.’ which Glanvilles Damant is proud to support as we understand the importance of these conversations between family members.

More information can be found at https://www.mountbatten.org.uk/highsheriffcampaign

We also understand that thinking about end-of-life care can be challenging but putting plans in place while you are able offers peace of mind for both you and your loved ones. Two crucial tools in this planning are Lasting Powers of Attorney (LPAs) and advance decisions (sometimes known as "living wills"). They ensure your wishes are respected if you become unable to make decisions for yourself.

What is a Lasting Power of Attorney (LPA)?

A Lasting Power of Attorney is a legal document that allows you to appoint one or more people (called "attorneys") to make decisions on your behalf. There are two types of LPAs:

1. Property and Financial Affairs LPA: This allows your attorneys to manage your money and property, such as paying bills, collecting benefits, selling your home, or managing investments. This LPA can be used as soon as it's registered, with your permission, or only when you lose mental capacity.

2. Health and Welfare LPA: This covers decisions about your daily care, medical treatment, and where you live. This LPA can only be used when you lack the mental capacity to make those decisions yourself. It's often the most relevant type when considering end-of-life care.

Why are LPAs important for end-of-life care?

Without an LPA, if you lose mental capacity, your family might have to apply to the Court of Protection to gain legal authority to make decisions for you. This process can be lengthy, expensive, and stressful for them during an already difficult time. An LPA simplifies this by pre-determining who can act on your behalf and what their powers are.

How LPAs Relate to End-of-Life Decisions

A Health and Welfare LPA is particularly powerful in the context of end-of-life care. It allows your chosen attorneys to make decisions about:

• Medical treatment: This includes consenting to or refusing specific treatments, even life-sustaining ones, if you've given them this authority directly in the LPA.

• Where you live: For example, deciding if you should move into a care home.

• Day-to-day care: Such as your diet, daily routine, and personal care.

You can include specific instructions or preferences within your LPA. For instance, you can state whether you wish to receive life-sustaining treatment, or if there are certain medical interventions you would explicitly refuse. This level of detail guides your attorneys and provides clarity on your wishes.

Advance Decisions (Living Wills)

An advance decision, or "living will," is a written statement that allows you to refuse specific medical treatments in the future. It becomes legally binding if you lose the capacity to make or communicate decisions yourself.

Key differences between Advance Decisions and Health and Welfare LPAs:

• Refusal only: An advance decision can only refuse treatment, not request it.

• Specific treatments: It's typically used to refuse particular treatments (e.g., ventilation or artificial feeding).

• Override: A valid and applicable advance decision to refuse life-sustaining treatment will override a Health and Welfare LPA, even if your attorney wishes to consent to that treatment. However, if your LPA specifically gives your attorney the power to consent to or refuse life-sustaining treatment, then the LPA takes precedence over an existing advance decision regarding such treatment. It's crucial to ensure these documents align to avoid conflict.