A professional’s guide to end of life care in motor neurone disease (MND)
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Putt<strong>in</strong>g affairs<br />
<strong>in</strong> order<br />
Power <strong>of</strong> At<strong>to</strong>rney<br />
A Last<strong>in</strong>g Power <strong>of</strong> At<strong>to</strong>rney (LPA – England and Wales) or an Endur<strong>in</strong>g<br />
Power <strong>of</strong> At<strong>to</strong>rney (EPA – Northern Ireland) is a legal document that allows<br />
a trusted person <strong>to</strong> make decisions on another person’s behalf if they are<br />
unable <strong>to</strong> communicate their wishes or lack capacity <strong>to</strong> make decisions. 11,12<br />
An LPA can cover decisions regard<strong>in</strong>g f<strong>in</strong>ancial and/or specified health/<br />
<strong>care</strong> related matters. An EPA allows one or more people <strong>to</strong> manage<br />
f<strong>in</strong>ancial affairs and property but doesn’t cover decisions on health<br />
or <strong>care</strong>. The person with <strong>MND</strong> must have capacity <strong>to</strong> understand and<br />
make the required decisions at the time they complete their Power<br />
<strong>of</strong> At<strong>to</strong>rney. The Power <strong>of</strong> At<strong>to</strong>rney will not come <strong>in</strong><strong>to</strong> force until the<br />
patient no longer has capacity <strong>to</strong> make their own decisions.<br />
Wills, trust funds and guardianship<br />
A will allows <strong>in</strong>structions <strong>to</strong> be left about what will happen <strong>to</strong> money,<br />
property and possessions when someone dies. This is essential for<br />
ensur<strong>in</strong>g wishes are carried out as expected, especially if there are<br />
problems with<strong>in</strong> a family or where partners are not married.<br />
Legal advice should be sought when mak<strong>in</strong>g a will <strong>to</strong> ensure its<br />
validity. If there are concerns regard<strong>in</strong>g guardianship <strong>of</strong> children,<br />
these will need <strong>to</strong> be clearly expressed. Some people may wish<br />
<strong>to</strong> set up trust funds <strong>to</strong> ensure the f<strong>in</strong>ancial future <strong>of</strong> their family.<br />
The person should also be encouraged <strong>to</strong> gather important<br />
paperwork, such as <strong>in</strong>formation about bank accounts, and <strong>to</strong> keep<br />
these <strong>to</strong>gether with the will.<br />
Organ and tissue donation<br />
Donation for transplant is not usually possible after a person dies<br />
from <strong>MND</strong>.<br />
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