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They answer the same question two different ways: an advance decision records your answers; an LPA appoints your person.
When both documents exist and touch the same treatment, the Mental Capacity Act does not simply pick the later one: a later LPA may make the advance decision invalid for the treatment it gives the attorney authority over; an earlier LPA is subject to the advance decision.
LPA made after the advance decision — and the LPA gives your attorney authority over that same treatment: your advance decision may no longer be valid for that treatment (Mental Capacity Act 2005, s.25(2)(b)). It is not out-ranked for one decision — it stops being an advance decision for that treatment at all. You chose a person after you chose an answer; the law treats the later appointment as withdrawing the answer.
Advance decision made after the LPA: your refusal binds for the treatment it specifies (provided it is valid and applicable) — your attorney's authority is subject to it (s.11(7)(b)), and the LPA survives intact for everything else. You chose an answer after you chose a person; the law honours the answer.
Neither document is "stronger" — but the two orders are not mirror images. Only an LPA that covers the same treatment counts; any other LPA changes nothing (s.25(7)). The real risk is doing both in one sitting in the wrong order, and never knowing you have unmade the refusal.
The clean setup isn't choosing between them — it's deciding, on purpose, what each one covers. A common, coherent shape: the AD holds the few specific, researched refusals you are certain about; the LPA holds everything else, trusting your attorney's judgment for the situations you can't foresee.
Date everything — which came first decides what survives.
Tell your attorney the AD exists and where it lives — an unknown AD is a courtroom, not a plan.
Make the advance decision last — or make it again — a later health & welfare LPA may make a refusal invalid for the treatment it covers; re-making the advance decision after the LPA reduces that risk — it does not settle every case, so where the two overlap, review both together and take advice.
Where a dispute is genuinely likely — family conflict, contested beliefs about care — say so to a professional while drafting. A short conversation now beats a best-interests meeting later.
Keep both documents and their dates in one place your people can findWith no AD and no LPA, no one you chose holds the decision. Clinicians decide in your best interests under the Act, consulting those who care for you — your family is consulted, not in charge. For many households that discovery, not the paperwork, is what starts the planning.
Reading this is the first step. Caring for a Parent covers the LPA route, the OPG registration timeline, and the conversation that has to happen first — prepared personally from a short intake about your household.
See Caring for a ParentWhich document does what, and what happens when the two collide, is answerable from the sections above. Writing an advance decision specific enough to be relied on is a drafting job: it has to name the treatments actually being refused, and it has to sit correctly alongside a health and welfare LPA rather than cancelling it out. There are two routes to a drafter, and we are straightforward about which one is ours.
Household dossier
Keep both documents, their dates, and their locations in one place your people can find.
See the household dossierInformational, not legal advice, and covers England & Wales only. Mental Capacity Act 2005 s.25 governs the collision rule described on this page — verify anything you rely on at GOV.UK or take professional advice.