If you have been diagnosed with dementia or another condition that could affect your decision-making later, a lasting power of attorney (LPA) lets you choose who decides for you if you cannot. In England and Wales, you make it under the Mental Capacity Act 2005 and register it with the Office of the Public Guardian (OPG).
Registering an LPA costs £92, or less if you are on a low income or certain benefits. It takes 8 to 10 weeks if there are no mistakes. You must have mental capacity when you make it. A diagnosis does not, on its own, mean you lack capacity. So the useful time to act is usually while decisions still feel clear.
You can also write down treatments you would refuse, in an advance decision. Scotland and Northern Ireland have different systems, covered in their own sections below.
Fees and rules were checked on 3 November 2026.
The Mental Capacity Act 2005 applies in England and Wales. It treats capacity as the ability to make a specific decision at the time it needs to be made. You might be able to make one decision but not another.
The test. You are unable to make a decision if, because of an impairment of the mind or brain, you cannot do one of these four things:
A condition is not enough. The Act says lack of capacity cannot be established merely by reference to a condition, or to your age or appearance. A dementia diagnosis is not, by itself, proof that you cannot decide.
Retaining it briefly is enough. If you can retain the information only for a short time, that does not stop you being able to make the decision.
Capacity can come and go. GOV.UK gives dementia and some mental illnesses as examples where capacity can come and go. It does not matter in law whether an impairment is permanent or temporary.
Five principles. You must be assumed to have capacity unless it is shown that you lack it. All practicable steps must be taken to help you decide first. An unwise decision is not proof of incapacity. Anything done for you must be in your best interests, and a less restrictive option must be considered.
You can make one type, or both. Each has its own form.
You do not need to own a home or have a lot of money to make a financial LPA. The OPG guide says it can help if managing bills or a bank account alone has become hard.
You can make an LPA online or on paper. You do not need a solicitor unless your situation is unusual. Someone else can fill in the forms, but you must make every choice.
1. Choose your attorneys. Attorneys must be 18 or over and have mental capacity. Someone who is bankrupt, or subject to a Debt Relief Order, cannot be your financial attorney. If you appoint more than one, you decide how they act:
You can also name replacement attorneys in case one can no longer act.
2. Choose a certificate provider. A certificate provider confirms that you understand the LPA and are not being pressured into it. They must be 18 or over, and either:
They cannot be a member of your family or your attorneys' families, or one of your attorneys. You may have to pay a professional to do it.
3. Sign in the right order. Everyone signs the same original document. Copies and digital signatures are not accepted. You sign first, then the certificate provider, then the attorneys. An impartial witness, aged 18 or over, must watch you and the attorneys sign. An attorney cannot witness your signature.
4. Tell the people you have chosen to notify. You can name up to five "people to notify". This is optional. Before registering, you send each one form LP3. They have three weeks to raise concerns with the OPG.
5. Register it. An LPA cannot be used until it is registered with the OPG. You or your attorneys can apply.
You apply for a reduction with form LPA120. If you get Universal Credit, you are assessed for the 50% reduction, not the full exemption. Fees are paid when you apply and are not refundable. The fee rose from £82 to £92 on 17 November 2025.
These points draw on the OPG's guidance.
If you are still being assessed, see our guides to cognitive screening test scores and mild cognitive impairment.
An LPA names who decides. An advance decision says what you refuse. You can have both.
An advance decision to refuse treatment is sometimes called a living will. You must be 18 or over and have capacity when you make it. It must name the treatments you refuse and the circumstances. If it is valid and applies to the situation, it is legally binding in England and Wales.
To refuse life-sustaining treatment, it must be:
How it interacts with an LPA. If you make an LPA after an advance decision, and give your attorneys power over the same treatment, the advance decision is no longer valid. The OPG guide says to mention any advance decision in your LPA, and to get legal advice if the two say very different things.
An advance statement sets out your wishes, beliefs and preferences for future care. It might cover where you want to be cared for, or how you like to do things. It is not legally binding, but anyone deciding for you must take it into account.
You can keep a copy of either in your medical records. Tell your family and carers where to find it.
An LPA cannot be made for someone who can no longer make the choices themselves. Instead, a relative or friend can apply to the Court of Protection to become a deputy.
As of 3 November 2026, GOV.UK lists these fees:
Deputies report to the OPG every year. The court usually appoints a personal welfare deputy only in limited cases. To manage only someone's benefits, you can apply to be an appointee instead.
The Mental Capacity Act 2005, LPAs and the OPG cover Wales in the same way as England. The GOV.UK guidance is also available in Welsh.
Scotland has its own law, the Adults with Incapacity (Scotland) Act 2000. An English or Welsh LPA is legally binding only in England and Wales.
Advance directives in Scotland have no statutory scheme like the one in England and Wales. The Mental Welfare Commission for Scotland says a clear advance directive may still provide important evidence of your wishes, and may sometimes have legal effect. Advance statements about treatment for a mental disorder have their own framework under Scotland's mental health law.
Northern Ireland does not have LPAs yet. The Mental Capacity Act (Northern Ireland) 2016 has only partly come into force. Its first phase started in October and December 2019.
Get advice from a solicitor or the Office of Care and Protection on 0300 200 7812.
The OPG helpline (0300 456 0300) can help with the process. Citizens Advice can also help. Talk to a solicitor if:
If you live in Ireland, the system is different again. See our guides to enduring power of attorney in Ireland and advance healthcare directives in Ireland.
Can I still make an LPA after a dementia diagnosis?
Often, yes. What matters is whether you have capacity to make the LPA when you make it, not the diagnosis. Your certificate provider must be satisfied that you understand it. If there is any doubt, a professional certificate provider or solicitor can help. Our guide to young-onset dementia covers what tends to come next.
Can my attorney use my LPA straight away?
A financial attorney can, once it is registered, if you choose that option. A health and welfare attorney can act only when you lack capacity for the decision in question.
How long does registration take?
GOV.UK says 8 to 10 weeks if there are no mistakes. It is usually quicker if you make it and pay online.
Does an LPA from England work in Scotland?
It is legally binding only in England and Wales. If you have property or live across the border, get legal advice.
This article is general information about how capacity law works in the UK. It is not legal or medical advice. Fees and rules change, so check GOV.UK, the Office of the Public Guardian (Scotland) or nidirect before you act. For help with your situation, contact Citizens Advice or a solicitor.
Reviewed by: Proco Team
Last updated: November 2026