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uk Death, bereavement & serious family crises cannot find advance directive • lost living will • hospital asked for living will • hospital asked for advance decision • advance decision missing • adrt missing • advance directive not located • can’t locate last wishes document • cannot find health power of attorney • missing health and welfare lpa • hospital needs lpa copy • emergency care plan missing • respect form missing • dnacpr form missing • end of life paperwork missing • family cannot find documents • incapacitated patient no paperwork • who decides without documents • best interests decision • urgent hospital decisions

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

Short answer

Ask the hospital to continue treating the patient in their best interests while you do a focused search, and immediately identify who (if anyone) has legal authority to speak for them (for example, a Health and Welfare power of attorney).

Do not do these things

  • Don’t guess what the document says, or “summarise it from memory” if you’re unsure.
  • Don’t assume the hospital can automatically “look it up” — many documents are not held on a central register.
  • Don’t delay urgent treatment while you search, unless clinicians advise it’s safe to wait.
  • Don’t hand over an unverified photocopy or screenshot if you can’t confirm it’s complete and belongs to the right person.
  • Don’t argue about “what they would want” in corridors or on speakerphone in public areas — ask for a quiet space or a scheduled 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 don’t find paperwork in time?”
    Request that care continues under normal consent/capacity rules (and “best interests” if the patient lacks capacity) while you search.

  2. Find out what exact document they mean (names vary).
    Ask the hospital which they’re asking for:

    • Advance Decision to Refuse Treatment (ADRT) (often called a “living will”)
    • Power of attorney for health/welfare (in England & Wales, this is a Lasting Power of Attorney (Health and Welfare))
    • Any emergency care plan they may have (for example, ReSPECT)
      This matters because each document is treated differently. ADRTs are often held as paper copies or scans (by the person, their GP, or in hospital records) rather than on a single national registry.

  3. Work out whether there is a power of attorney — and which UK system applies.

    • England & Wales: If there is a Health and Welfare LPA, the attorney(s) should be contacted and involved. If you have the registered LPA details, the attorney (or the donor, if they still can) can create/share an access code so the hospital can view it online. If nobody knows whether an LPA exists, you can apply to search the Office of the Public Guardian (OPG) registers (including urgent enquiry routes where appropriate).
    • Scotland: Powers of attorney are registered with the Office of the Public Guardian (Scotland) and can be verified/searched via their public register processes.
    • Northern Ireland: Powers of attorney operate differently (commonly Enduring Power of Attorney for property/finance), and health/welfare authority is not the same as England & Wales. If the patient is usually resident in NI, ask the hospital what documentation they need and contact the relevant NI court/office route if you suspect an EPA is involved.

  4. Do a 20-minute “high-yield” search before you widen it.
    Check places people commonly store these documents:

    • The patient’s phone (Files/Notes/email), and any cloud storage they used
    • A clearly labelled folder at home (“will”, “LPA”, “advance decision”, “ReSPECT”, “DNACPR”)
    • Wallet/purse cards or a “message in case of emergency” note
    • If they live in a care setting: ask the care home for copies kept in records

  5. Call the most likely holders of a copy and ask them to send it securely to the ward.

    • GP surgery (ask if an ADRT/advance care plan is scanned into the record, and to send it securely to the hospital)
    • Solicitor who handled wills/LPAs
    • Any community nursing/palliative care team involved (they may hold ReSPECT/advance care planning paperwork)

  6. If the patient has no family/friends who can be consulted, say this clearly.
    Ask the ward team: “If there’s no one appropriate to consult, can you arrange an Independent Mental Capacity Advocate (IMCA) if required for this decision?”
    (IMCAs can be involved for certain serious decisions when someone lacks capacity and has no one suitable to represent them.)

  7. Create a safe “holding position” for the next few hours.
    Ask the hospital to document:

    • “Advance decision / power of attorney reported but not currently available”
    • Names/contact numbers of people searching
    • When you will update them (for example, “call back by 5pm”)
      This reduces the risk of mixed messages across shift changes.

What can wait

  • You do not need to resolve every future treatment scenario today.
  • You do not need to decide about complaints, legal action, or changing documents right now.
  • You do not need to perfectly reconstruct the patient’s wishes from memory under pressure — focus on locating the correct paperwork or confirming who has legal authority.

Important reassurance

This is a very common crisis point: documents get misfiled, held by a solicitor, or exist only as scans. Hospitals are used to proceeding safely when paperwork isn’t immediately available, and you’re allowed to take a breath and search methodically.

Scope note

These are first steps to stabilise the situation and prevent avoidable mistakes. If big decisions are imminent, you may need dedicated time with the consultant/ward team, and (where appropriate) support services such as advocacy and the hospital’s patient support service.

Important note

This is general information, not legal or medical advice. The UK has different legal frameworks across England & Wales, Scotland, and Northern Ireland. Hospital staff can explain what they need for the decision in front of them and what options exist if documents can’t be found in time.

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