Planning for Future Care: Health and Welfare LPA vs. Advance Decisions Explained

A Health and Welfare Lasting Power of Attorney is a legal document that allows you to appoint one or more people (known as attorneys) to make decisions about your healthcare and personal welfare if you lose the mental capacity to do so. These decisions can include where you live, what medical treatment you receive, and your day-to-day care.

Key Features:

• It covers a broad range of decisions about health and personal welfare
• You choose trusted individuals to act on your behalf
• Includes everyday matters like what you eat, where you live, and more serious decisions like consenting to or refusing medical treatment
• It only comes into force if you lose the mental capacity to make decisions for yourself
• Must be registered with the Office of the Public Guardian (OPG) to be legally valid

An Advance Decision is a legal document that allows you to specify medical treatments you want to refuse in the future, should you become unable to make those decisions yourself. 

It focuses only on refusal of medical treatment, and you cannot use it to express choices or preferences about non-medical matters like daily care or living arrangements.

Key Features:

• Limited to refusal of specific medical treatment
• Focuses on what treatments you do not want
• No Need for Attorneys: It doesn’t require someone else to make decisions on your behalf
• It is only used if you lose the ability to make decisions and are facing the specific circumstances outlined in the document
• Does not need to be registered but must meet strict legal criteria to be valid

1. Range of Decisions

• Health and Welfare LPA: Covers all aspects of personal welfare and healthcare decisions, from care needs to serious medical treatments. It allows your attorney(s) to make a wide range of decisions, not just about healthcare, but also about personal welfare. This may include decisions about your daily routine, living arrangements. With an LPA, you have the assurance that someone who knows your values and preferences will speak for you. This is especially important when situations arise that you may not have anticipated. Unlike an Advance Decision, where specific refusals are laid out in advance, the LPA allows for real-time decisions. If your health condition changes or new medical treatments become available, your attorney can adapt to these developments, making decisions based on your current circumstances. Your attorney can ensure that decisions are made considering your overall well-being, quality of life, and any changing medical advice. They are also able to liaise with healthcare professionals on your behalf.
• Advance Decision: Is limited to refusing specific medical treatments in particular circumstances. If you have strong feelings about refusing life-sustaining treatments, such as artificial ventilation or resuscitation, an Advance Decision allows you to make this clear in writing, providing clarity to healthcare providers about your wishes. You don’t need to appoint someone to act on your behalf, It’s just a document outlining specific medical refusals, leaving doctors to interpret it without someone advocating for you in real-time. 

2. Flexibility

• Health and Welfare LPA: More flexible, as it allows your attorneys to make decisions based on your best interests, taking into account your wishes, values, and current circumstances.
• Advance Decision: Less flexible, as it is focused solely on the refusal of treatment, and once made, the document must be followed as long as it is valid.

3. Appointing a Representative

• Health and Welfare LPA: Involves appointing someone to act as your voice. This ensures decisions are made by someone who knows and understands your preferences.
• Advance Decision: You don’t appoint anyone. 

4. Registration and Formality

• Health and Welfare LPA: Must be formally registered with the Office of the Public Guardian before it can be used.
• Advance Decision: No need for registration, though it must be written clearly, signed, and witnessed.

The choice between a Health and Welfare LPA and an Advance Decision depends largely on your personal preferences and circumstances.

If you prefer a more flexible approach, where someone you trust makes decisions based on your best interests, then a Health and Welfare LPA is likely the better option. It ensures that all aspects of your care are covered, and your wishes are interpreted in real-time.

However, if your priority is to simply refuse specific medical treatment, especially life-sustaining treatment, then an Advance Decision may suit your needs. It gives clear instructions to healthcare professionals about what specific treatment you do not want, in specific circumstances, without the need to involve others in the decision-making process.

It’s worth noting that you don’t necessarily have to choose between these two options. Some people find it useful to have both a Health and Welfare LPA and an Advance Decision. This allows for you to express your wish to refuse of specific treatment while also appointing someone to manage the decisions about your health and welfare.

Both the Health and Welfare LPA and the Advance Decision have their place in future healthcare planning. By understanding the differences and advantages of each, you can make an informed decision about how best to protect your rights and ensure your wishes are followed should you lose the capacity to make decisions for yourself. Whether you choose an LPA, an Advance Decision, or a combination of both, the key is to have a plan in place that reflects your values and provides peace of mind for you and your loved ones.

Our private client team have offices in Hinckley, Leicestershire and Leamington Spa, Warwickshire.