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NHS HIGHLAND: Who will make decisions for you if you were no longer able to make them yourself?


By Andrew Dixon

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NHS Highland was encouraging people throughout World Dementia Awareness Month to consider planning for a time when you may no longer be able to make decisions for yourself, writes Dr Allan MacDonald, consultant geriatrician and physician at Raigmore Hospital, Inverness.

Dr Allan MacDonald.
Dr Allan MacDonald.

Dementia is the leading cause of death in the UK, according to the Office for National Statistics.

As a consultant geriatrician and physician working at Raigmore Hospital in Inverness, I regularly speak with families during difficult times for their loved ones. It can be a stressful and emotional time for everyone involved, and difficult decisions sometimes have to be made.

What is even more concerning is that dementia can strike earlier than many people may think: an estimated 42,000 under-65s live with the condition across the UK.

I often speak to families and loved ones about Power of Attorney and it is fair to say that many people are not fully aware of the benefits of having Power of Attorney secured for your family members – or even yourself.

A lot of people I speak to assume that, in situations where you no longer have capacity to make decisions for yourself, a member of your family, such as a husband or wife, can make welfare and/or financial decisions on your behalf. However, legally this is not the case. Granting a Power of Attorney allows you to nominate who would make decisions for you if you were no longer able to make them yourself. This would be someone you trust, such as a relative or close friend.

Power of Attorney is a written document giving someone else authority to take actions or make decisions on behalf of the person concerned. The individual chooses the person or persons they want to help them, called an attorney, and decides what powers they should have.

Not having Power of Attorney secured can have a significant impact on patients and their families, especially when a loved one is diagnosed with a long-term illness such as dementia. It can create long delays in accessing necessary services or being in hospital longer than required.

I have worked with many families in this position over the years and it comes as a great shock to them when they learn that they don’t automatically have the right to make decisions for their mum, dad, siblings or grandparents.

Without a Power of Attorney, your family or friends will have to apply to the courts for a Guardianship Order to allow them to make decisions on your behalf and this can be a lengthy and far more costly process.

When you appoint a family member or friend as an attorney, you are taking a positive step by choosing someone you trust to look after your affairs and not leaving that decision to the courts.

I would recommend that families look to secure Power of Attorney as soon as they possibly can. There is a common misconception that you can still appoint an attorney upon learning of a diagnosis of a long-term illness. You can only appoint an attorney when you have capacity. The process can also be lengthy, in many cases taking over a month to complete. It can also be an expensive process, but you can’t put a price on peace of mind.

We plan to work with partner agencies to continue to highlight what the Power of Attorney process looks like, how you can secure it for yourself or a loved one and the many benefits of having it in place. An increase in the number of people having Power of Attorney can have extremely positive outcomes for our health and social care services and the communities we serve.

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