Power of attorney for dementia: a step-by-step guide for families

Setting up a lasting power of attorney (LPA) is one of the most important legal steps you can take when someone you care about has been diagnosed with dementia. While the topic might feel overwhelming or premature, an LPA is a legal tool that lets you choose someone you trust to make decisions for you, and LPAs can make things easier for you and the people you are close to as your dementia progresses.

The key thing to understand is that an LPA must be set up while your loved one still has the mental capacity to make this decision themselves. You could still make a valid will and a Lasting Power of Attorney (LPA); the key requirement is that you have the mental capacity to do so. This means acting sooner rather than later, but it doesn't mean rushing into decisions without proper consideration.

Understanding what an LPA involves, when to start the process and how to navigate the application can help your family feel more confident about protecting your loved one's future interests whilst respecting their autonomy and wishes.

Understanding the two types of power of attorney

There are two types of LPA, each covering different aspects of decision-making. Understanding both types helps you decide which ones your family needs.

A property and financial affairs LPA covers all money-related decisions. This includes managing bank/building society accounts, bills, benefits, pensions, and buying and selling property. This type of LPA can be used as soon as it's registered, even if your loved one still has capacity, provided they've given permission. This can be particularly helpful for families where the person with dementia wants support with increasingly complex financial tasks but isn't ready to hand over complete control.

A health and welfare LPA covers decisions about medical treatment, care arrangements and daily living choices. Unlike the financial LPA, this can only be used when your loved one lacks the mental capacity to make these specific decisions themselves. This might include choices about where they live, what medical treatments they receive and day-to-day care decisions.

Many families find it helpful to set up both types of LPA, as dementia typically affects both financial management and health-related decision-making over time. It currently costs £82 to register each LPA unless you get a reduction or exemption. This means it costs £164 to register both a property and financial affairs LPA and a health and welfare LPA.

The decision about which type of LPA to prioritise often depends on your loved one's current needs and concerns. If they're already struggling with financial tasks, the property and affairs LPA might feel more urgent. However, many families choose to complete both applications simultaneously to avoid having to revisit the process later when capacity might be more limited.

When to start the process

Timing is crucial when it comes to LPAs and dementia. You can only set one up at a time when you have the capacity to make the decision of having an LPA yourself. The earlier you start the conversation, the more time your loved one has to consider their options and make informed choices about who they want to appoint.

Mental capacity in legal terms means the ability to understand information relevant to the decision, retain that information, use it to make a decision, and communicate that decision. People with dementia may retain capacity for LPA decisions even when they're struggling with other areas of their lives. However, capacity can fluctuate, and what matters is whether they have capacity at the time the LPA is being made.

The ideal time to discuss LPAs is shortly after a dementia diagnosis, when your loved one can fully participate in choosing their attorneys and expressing their preferences. However, it's never too late to explore the option – many people in the early to moderate stages of dementia still have the capacity to make these important decisions.

If you're unsure about your loved one's capacity, their GP can provide guidance, or you might consider a formal capacity assessment from a qualified professional. It's worth noting that if you don't have sufficient mental capacity when making a Lasting Power of Attorney (LPA), then the only alternative, if your loved ones want to make decisions on your behalf, is to apply to the Court of Protection for a Deputyship Order instead. This process is more complex, expensive and time-consuming than setting up an LPA.

Step-by-step application process

The LPA application process has become more straightforward in recent years, with much of it now available online through the government's LPA service. However, it's still important to take your time and get it right.

Starting the application begins with gathering the necessary information. You'll need details of the person making the LPA (called the 'donor'), the people they want to appoint as attorneys, and any preferences or restrictions they want to include. The GOV.UK website provides comprehensive guidance on completing the forms.

Choosing attorneys is perhaps the most crucial decision. Your loved one can appoint multiple attorneys and decide whether they should act jointly (all decisions made together), jointly and severally (each can act independently), or a combination of both for different types of decisions. They should also consider appointing replacement attorneys in case their first choices are unable to act.

Good attorneys should be trustworthy, reliable, and willing to take on the responsibility. They don't need to be family members – close friends can also be suitable choices. However, they must be over 18 and not bankrupt (for financial LPAs). Consider people who understand your loved one's values and preferences, and who are likely to be available when needed.

The certificate provider is an independent person who confirms that your loved one understands what they're doing and isn't being pressured. This can be someone who's known them personally for at least two years, or a professional such as a GP, solicitor or social worker.

Completing and registering the forms requires attention to detail, as mistakes can cause delays. Once submitted, the Office of the Public Guardian will register the LPA if everything is in order. This process typically takes 8-10 weeks, though it can be longer during busy periods.

Common mistakes to avoid

Many families encounter preventable problems when setting up LPAs. Being aware of common pitfalls can save time, money and stress.

Waiting too long is the most serious mistake. Capacity can decline more quickly than expected, and once someone lacks capacity, it's too late to create an LPA. If you're considering whether now is the right time, the answer is usually yes.

Not discussing preferences thoroughly can lead to attorneys making decisions that don't reflect the person's wishes. Use the LPA forms to record specific preferences about care, treatment, and financial management. These conversations, while sometimes difficult, ensure that the person's voice remains central to future decisions.

Choosing inappropriate attorneys happens when families don't think carefully about who would actually be best placed to make decisions. Consider practical factors like geographical location, availability, and the person's ability to handle the emotional and administrative demands of being an attorney.

Inadequate record-keeping creates problems later. Attorneys have legal duties to keep records of decisions and financial transactions. Setting up good systems from the start makes this much easier.

What happens after registration

Once your LPA is registered, it becomes a powerful legal document, but with that comes important responsibilities. Without an LPA, you may not legally be allowed to make decisions on the person's behalf, which is why registration is so important.

Using the financial LPA can begin immediately if the donor has given permission, or automatically when they lack capacity for specific financial decisions. Attorneys must always act in the person's best interests and follow any preferences or restrictions recorded in the LPA.

Using the health and welfare LPA only begins when the person lacks capacity for specific health or care decisions. This requires careful assessment – someone might lack capacity for complex medical decisions but still have capacity for daily choices about food or activities.

Ongoing responsibilities include keeping detailed records, consulting with the person wherever possible, and involving them in decisions to the greatest extent they can participate. Attorneys should also keep up to date with the person's condition and changing needs.

Regular reviews help ensure the LPA continues to work effectively. As dementia progresses, the balance between supporting independence and providing protection naturally shifts and attorneys need to adapt their approach accordingly.

Moving forward with confidence

Setting up an LPA isn't about taking control away from your loved one – it's about ensuring their voice continues to be heard and their interests protected as their condition changes. The Alzheimer's Society provides excellent resources to help families understand the process, while Dementia UK offers specialist guidance through their Admiral Nurses.

Many families worry about whether they're doing the right thing by discussing LPAs, particularly early in the dementia journey. However, most people with dementia appreciate having the opportunity to make these important choices while they still can. It's about planning ahead together, not making assumptions about what someone would want.

If the process feels overwhelming, remember that professional help is available. Solicitors who specialise in elder law can guide you through the process, though many families successfully complete the applications themselves using the online service and guidance materials.

Taking action to set up LPAs demonstrates love and respect for your family member's autonomy. By ensuring these legal protections are in place while your loved one can still participate in the decisions, you're helping to secure their future whilst honouring their present capacity and dignity.