Working with families, attorneys, advocates, and professionals

Decisions about capacity and restriction commonly involve other people, but their roles differ. Family and friends usually know the person’s preferences, routines and what helps them feel safe. Being next of kin, however, does not give automatic legal decision-making power.

Some people will have a health and welfare attorney or a court-appointed deputy authorised to make specific decisions; others may need an independent advocate. Staff should check records for any legal authority, involve the appropriate people, and escalate uncertainty rather than deferring to the loudest relative.

Even when someone lacks capacity for a particular decision, they should be involved as far as possible. Family members, attorneys, advocates, nurses, GPs, social workers, therapists and care home staff can all contribute relevant information, but the person’s own wishes and experiences remain central to the decision.

Disagreements are common. Families may ask for more restriction out of fear, or less restriction because they prioritise freedom. Staff may focus on reducing risk while advocates prioritise rights. Good practice is to return the discussion to the specific decision, the evidence about capacity, the person’s values, and the least restrictive safe option.

Important points about involvement

• Next of kin does not automatically mean decision-maker.
• Attorneys and deputies only act within their legal authority.
• Advocacy may be needed to support involvement and protect rights.
• The person's own wishes should remain central wherever possible.

Family views are important, but lawful decisions depend on the person's capacity, wishes, legal authority, best interests, and the least restrictive option.