Families, attorneys, advocates, and sharing information

Families, friends, and other supporters often know the person well and can help staff understand routines, preferences, fears, and communication style. Their involvement can improve care, but they do not automatically replace the person's own voice or legal rights.

Keeping the person at the centre

• Speak to the person first where possible: do not talk over them as though they are not there.
• Ask what support they want: some people want relatives involved closely, while others want more privacy.
• Use supporter knowledge well: families may help staff understand what words, routines, or approaches are most effective.
• Do not hand over decision-making casually: being the nearest relative or next of kin does not automatically give someone legal authority to consent on the person's behalf.

Who may have lawful authority?

When a person has capacity, they decide. If they lack capacity for the decision, staff may need to consult others and follow the best interests process. In some cases, another person may have formal authority that staff must recognise.

• Health and welfare attorney: a valid Lasting Power of Attorney can allow an attorney to make certain health and welfare decisions, but only when the person lacks capacity for that decision.
• Court-appointed deputy: in some cases a deputy may have authority to make welfare decisions.
• Advance decision to refuse treatment: for medical treatment, a valid and applicable advance decision must be respected.
• Independent Mental Capacity Advocate (IMCA): this may be required for serious medical treatment or certain accommodation decisions when there is no appropriate person to consult.

The names and powers of formal representatives differ across the UK. For example, Lasting Powers of Attorney and deputies are England and Wales terms. Scotland and Northern Ireland have their own routes for authority, so staff should check documents and seek senior advice rather than guessing from family relationships.

Sharing information carefully

Where the person has capacity, ask what they are happy to be shared and with whom. Where the person lacks capacity, information sharing should still be relevant, proportionate, and in line with care needs, best interests, safeguarding duties, and local policy.

Families and supporters matter, but consent and confidentiality still belong to the person wherever they have capacity. Legal authority should never be guessed or assumed.