Quick summary
There are two lasting powers of attorney, not one. Most people set up the property and financial affairs LPA through a bank or solicitor and never do health and welfare, which is the one that matters when decisions about care get made. Each costs £92 to register and takes 8 to 10 weeks.
The two types
Property and financial affairs | Health and welfare | |
|---|---|---|
Covers | Bank accounts, bills, pensions, benefits, investments, selling the house | Daily routine, medical treatment, where the person lives, and the type of care they receive |
Can be used | As soon as it is registered, with the person’s permission | Only when the person is unable to make that decision themselves |
How often it gets made | Very commonly | Far less often |
When it matters most | Managing money as capacity declines | Every conversation about care, hospital discharge and where someone lives |
Source: GOV.UK, Make, register or end a lasting power of attorney.
Why the second one gets skipped
Usually because of how people come to it. Someone sets up an LPA while making a will, or after a bank suggests it, and the conversation is about money. The health and welfare one sounds like something for later, and later is the exact point at which it can no longer be made.
There is also a reasonable assumption underneath it: that as next of kin you will be consulted about care anyway. You will be listened to. You will not have the legal authority to decide.
What difference it actually makes
Three situations where families discover the gap, usually at the worst moment.
Hospital discharge. A ward is planning a discharge you think is unsafe, or is proposing a care home place. Without a health and welfare LPA, your view is a relative’s opinion to be taken into account. With one, and where the person lacks capacity for that decision, you are the decision maker.
Our guide to hospital discharge covers how fast those 48 hours move.
Choosing care. Whether someone stays at home with support or moves into a care home is a health and welfare decision, and it is the biggest one most families face.
Medical treatment. If the LPA is drafted to include it, an attorney can give or refuse consent to treatment on the person’s behalf when they cannot decide. There is a specific section about life-sustaining treatment which has to be completed deliberately.
What an attorney cannot do
- You cannot override someone who has capacity. A health and welfare LPA only becomes usable when the person cannot make that particular decision. An adult with capacity can make choices you think are unwise, and our piece on refusing care goes into that.
- You must act in their best interests, and in the least restrictive way, under the Mental Capacity Act 2005.
- You cannot demand a particular NHS treatment. You can consent or refuse, within the terms of the LPA.
- You cannot ignore what they wanted. Their past wishes and values are part of the best interests test.
What it costs and how long it takes
- £92 to register each LPA with the Office of the Public Guardian, so £184 for both. Reductions and exemptions are available on a low income or on certain benefits.
- 8 to 10 weeks to register, if there are no mistakes. Mistakes are common and restart the clock.
- You can do it yourself on GOV.UK, or use a solicitor, which costs more and reduces the chance of an error.
- Office of the Public Guardian: 0300 456 0300.
An LPA cannot be used until it is registered, so making one in an emergency does not work.
The deadline nobody tells you about
An LPA can only be made while the person has capacity to make it. They must understand what they are doing and choose their attorneys themselves.
A dementia diagnosis does not automatically remove that capacity, and early after diagnosis is usually still fine. What it does is put a clock on it. Our first month after a diagnosis guide puts LPAs at the top of the list for exactly this reason.
If the moment passes, the alternative is deputyship through the Court of Protection. That is slower, considerably more expensive, involves ongoing supervision and reporting, and the court does not often grant health and welfare deputyships at all. Families discover this at the point they most need a quick decision.
Practical points people get wrong
- Appoint more than one attorney if you can, and think hard about “jointly” versus “jointly and severally”. Jointly means every decision needs all of you, which sounds safer and is impractical in a crisis.
- Name replacements, in case an attorney dies or cannot act.
- Complete the life-sustaining treatment section deliberately, after a conversation, not as an afterthought.
- Use the preferences and instructions sections sparingly. Over-specific instructions can make an LPA unworkable, or invalid.
- Tell people it exists. An LPA in a drawer that the GP, the hospital and the care provider know nothing about does no work. Give copies to the surgery and keep one accessible.
- Both partners should make them. Couples often do one and not the other.
Also worth doing at the same time
- An advance statement, setting out preferences about care, routine and where someone wants to live. Not legally binding, and genuinely useful.
- An advance decision to refuse treatment, which is legally binding if properly made. Take advice, since it interacts with the LPA depending on which was made later.
- A will, and a conversation about funeral wishes.
- Practical access: knowing where documents, keys and account details are.
Frequently asked questions
Do I need both types of LPA?
Most people should have both. They cover completely different decisions, and the health and welfare one is the one that governs care.
Can my mum still make one if she has dementia?
Often yes, particularly early on. What matters is whether she understands the decision at the time she makes it. A solicitor can assess and record that, which also makes the LPA harder to challenge later.
What does it cost?
£92 to register each one with the Office of the Public Guardian, with reductions and exemptions available. Solicitors charge on top for drafting.
Can I use it straight away?
The property and financial affairs LPA can be used once registered, with the person’s permission. The health and welfare one only when they cannot make the decision themselves.
Is next of kin not enough?
No. “Next of kin” has no formal legal standing for decision making in England and Wales. You will be consulted, and you will not have authority.
What if we have left it too late?
You would need to apply to the Court of Protection for deputyship, which is slower and more expensive, and health and welfare deputyships are granted relatively rarely. Take legal advice.
About Visiting Angels Cheshire East
Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages of East Cheshire, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.
- You choose your caregiver, and meet them before care starts.
- No visit is ever shorter than an hour.
- You see the same faces. Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (Skills for Care, 2025).
- Carers trained in dementia, Parkinson’s, stroke recovery and complex care.
- Live-in care available, up to full time.
Sharon’s mother had been having visits for a fortnight when she wrote this:
“It is not something we ever thought we would need but Visiting Angels have been wonderful. They came to see us to find out exactly what we needed, even though we weren’t completely sure ourselves, but through our conversation we were able to put a package of support in place. They offered advice on other things that were available to us as well particularly financially. They put our minds at ease during what was quite a stressful time in our lives.”
Sharon Thornton, Google review
Not sure what you need yet? Start with a free assessment
Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:
- Work out what is actually difficult, and which times of day.
- Talk through a realistic package, and what it would cost.
- Look at the money with you, and point you towards the funding, benefits and grants you may be entitled to.
- Tell you honestly if the paperwork should come first, because if an LPA is not in place, that is often the more urgent job.
If you are getting the arrangements in order, call us on 01625 720157. You can also send an enquiry, and you can see what our services cover.
Authored by Dr Niall Jawad, Managing Director, Visiting Angels Cheshire East.
Published 27 September 2026. Last updated 27 September 2026.
This article is general information about lasting powers of attorney, not legal advice, and no substitute for advice from a solicitor about your circumstances. LPAs are legal documents with lasting consequences and errors can invalidate them. Fees, forms and processing times change; check GOV.UK or contact the Office of the Public Guardian on 0300 456 0300. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss arising from reliance on this article.
