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What to do if…
a hospital asks for an advance directive or living will and you cannot find it

Produced and maintained by PanicStation.org Published: Last reviewed: Editorial policy UK guide

Short answer

Ask the hospital what decision is needed now, ask them to continue using the normal consent and capacity process while you search, and identify whether anyone has legal authority to speak for the patient.

Do not do these things

  • Don’t guess what the document says or summarise it from memory if you are unsure.
  • Don’t assume the hospital can automatically look it up; many advance care documents are kept as paper copies, scans, or records held by a GP, solicitor, care provider, or family member.
  • Don’t delay urgent treatment while you search unless the clinical team says it is safe to wait.
  • Don’t present a partial, old, or uncertain copy as complete; tell the ward exactly what you know and what you cannot confirm.
  • Don’t argue about the patient’s wishes in public areas or on a speakerphone in a corridor; ask for a quiet space or a planned call.

What to do now

  1. Stabilise the immediate decision with the clinical team.
    Ask: “What decision is needed today, what is the deadline, and what happens if we do not find the paperwork in time?”
    If the patient cannot make the decision now, ask the team to document that paperwork is being searched for and that any urgent decisions are being made under the relevant consent and capacity process.

  2. Find out exactly what document the hospital means.
    Ask whether they are asking for:

    • an Advance Decision to Refuse Treatment (ADRT), sometimes called a living will
    • a Health and Welfare Lasting Power of Attorney (LPA) in England and Wales
    • a welfare power of attorney in Scotland
    • an advance statement, care plan, DNACPR form, or ReSPECT plan

    These are not all the same. An ADRT may be legally binding if it is valid and applies to the situation. A ReSPECT plan is a clinical record of emergency care and treatment recommendations, not the same thing as an ADRT or LPA.

  3. Work out whether anyone has legal authority.

    • England and Wales: If there is a Health and Welfare LPA, ask the attorney to speak to the ward. If the LPA can be viewed online, the donor or attorney can usually generate an access code for the hospital. Older LPAs may need the registered paper document or a certified copy.
    • Scotland: Ask whether there is a welfare power of attorney. The hospital may ask for the attorney’s certificate, the registered document, or a public register search. If a search is urgent, ask the hospital or relevant professional to mark the request as urgent.
    • Northern Ireland: Enduring powers of attorney in Northern Ireland are for managing property and financial affairs and are not the same as an England and Wales Health and Welfare LPA. Ask the hospital what documentation they need and, if an EPA may exist, use the Northern Ireland court or Office of Care and Protection route for guidance.

  4. Do a short, high-yield search before widening it.
    Check the places most likely to hold the document:

    • the patient’s phone, email, Files app, Notes app, and cloud storage
    • a home folder labelled “will”, “LPA”, “advance decision”, “living will”, “ReSPECT”, or “DNACPR”
    • wallet or purse cards saying where emergency documents are kept
    • care home or supported living records, if the patient lives in a care setting

  5. Contact likely holders of a copy.
    Ask them to send any copy securely to the ward or hospital team:

    • the patient’s GP surgery
    • the solicitor who helped with wills, powers of attorney, or future planning documents
    • any community nursing, hospice, or palliative care team involved
    • the care home, home care agency, or supported living provider, if relevant

  6. If there is nobody suitable to consult, say that clearly.
    Tell the ward: “I do not know anyone suitable who can speak about the patient’s wishes.” In England and Wales, ask whether an Independent Mental Capacity Advocate is required for this decision. In Scotland or Northern Ireland, ask the hospital what local advocacy route applies.

  7. Create a clear holding position for the next few hours.
    Ask the hospital to record:

    • “Advance decision, power of attorney, or care plan reported but not currently available”
    • who is searching and how they can be contacted
    • what has already been checked
    • when you will update the ward next

What can wait

You do not need to solve every future treatment decision today. You do not need to start complaints, legal action, or document changes now. You do not need to perfectly reconstruct the patient’s wishes from memory; focus on finding the right document, identifying any legal decision-maker, and keeping the ward updated.

Important reassurance

This is a common crisis point. Documents can be misfiled, held by a solicitor, scanned into GP records, kept in a care record, or known about but not immediately available. Hospitals are used to making safe interim decisions while paperwork is being checked.

Scope note

These are first steps only, to stabilise the situation and reduce avoidable mistakes. Later decisions may need a proper discussion with the consultant, the ward team, an advocate, a solicitor, or another specialist service.

Important note

This is general information, not legal, medical, financial, therapeutic, or professional advice. The UK has different legal frameworks across England and Wales, Scotland, and Northern Ireland, so ask the hospital which process applies to the patient and the decision being made now.

Additional Resources

Closely connected guides that may be useful during the same situation or its immediate aftermath.

About this guide

This guide was produced and is maintained by PanicStation.org using its published editorial process. Official and specialist sources are checked where relevant, and AI-assisted tools may be used for drafting, organisation, and consistency checks. The site operator remains responsible for publication, revision, and removal decisions.

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