Who Gets to Make Decisions for You? Why Everyone Should Think About Their Circle of Care
One of the questions that came up during a recent Dead Curious Community Conversation Café was:
"As a queer, unmarried person, what do I need to consider when thinking about who I want to have access to me and who can make decisions for me if something happens to me?"
It's an excellent question, but it's one that extends far beyond the queer community.
Many of us don't live within the traditional image of a married couple with children and nearby relatives who naturally step into caring roles. We may be single, divorced, widowed, estranged from family, child-free, living alone, part of a blended family, in a long-distance relationship, practising various forms of non-monogamy, or simply have friends who know us more deeply than some of our biological relatives ever could.
Families and support networks come in countless forms. I've spent a lot of time thinking about chosen family and who I'd want beside me if I became seriously ill or died. Many queer people learn early on that the people who know us best, love us most and understand our values aren't always the people the law recognises first. But I don't think this is only a queer conversation. It's one that everyone can benefit from having, because very few of us fit neatly into a single idea of what a family should look like.
Rather than asking, "Who is my next of kin?", I think a more useful question is “Who is my Circle of Care?”
Your Circle of Care is made up of the people you trust to support you, advocate for you and carry out your wishes if you're no longer able to do so yourself. For some people, that might include a spouse or adult children. For others, it might be siblings, neighbours, close friends, former partners or other chosen family. Most of us have a network of people who care about us, even if they each play different roles. Thinking about your Circle of Care isn't about predicting the worst. It's about recognising the relationships that already sustain your life and considering whether the law and your paperwork reflect those relationships.
"Next of kin"
One of the biggest misconceptions is that being someone's "next of kin" automatically gives them the legal right to make decisions on your behalf. In England and Wales, it doesn't. If you're admitted to hospital, you'll usually be asked to provide the name of your next of kin. This simply tells the hospital who they should contact in an emergency. It doesn't give that person legal authority to make healthcare decisions, manage your finances or override your wishes.
It's still worth checking that your emergency contacts are up to date with your GP, your workplace and in your mobile phone, but it's important to understand that this is only one small piece of a much bigger picture.
Who would make healthcare decisions for you?
If you lose the ability to make decisions because of illness or injury, healthcare professionals are responsible for making decisions in your best interests. They'll usually consult the people closest to you, but those people don't automatically have the legal authority to make decisions on your behalf. If there's someone you specifically want to have that responsibility, you'll need to create a Health and Welfare Lasting Power of Attorney (LPA).
This allows you to appoint someone you trust to make decisions about things such as medical treatment, your daily care, where you receive care and, if you choose, life-sustaining treatment. For many people, this provides reassurance that the person who understands their wishes best, whether that's a partner, sibling, close friend or chosen family member, will be able to advocate for them if they're no longer able to speak for themselves.
Who could manage your finances?
Now imagine you're in hospital for several weeks or months. Who would pay your rent or mortgage? Deal with your bank? Cancel subscriptions? Contact utility companies? Access your accounts if bills needed paying?
A Property and Financial Affairs Lasting Power of Attorney allows someone you've chosen to manage these practical matters if you lose mental capacity. Without one, even people who care deeply about you may have to apply to the Court of Protection before they can help, which can be a lengthy, expensive and stressful process.
Who would hospitals contact?
Although "next of kin" has no special legal meaning, it's still worth asking yourself some practical questions. Is the person listed as your emergency contact actually the person you'd want called first? Does your GP have the right contact details? Is the emergency contact stored in your mobile phone up to date? It's surprisingly common for people to realise they're still listing an ex-partner, a parent they rarely speak to, or someone they simply forgot to update years ago.
Who would visit you?
Healthcare settings have become much more aware that families come in many different forms, and most professionals will do their best to involve the people who matter to you. Even so, difficult situations can arise if people disagree about who should be involved, particularly if your closest relationships aren't immediately obvious to others. Having conversations in advance with the people in your Circle of Care can help avoid uncertainty at an already stressful time.
What happens if you die without a will?
This is one of the areas where the law can differ most dramatically from our lived relationships. If you die without a will in England and Wales, the rules of intestacy decide who inherits your estate. Unmarried partners do not automatically inherit. Neither do close friends or chosen family members, no matter how significant they were in your life. If you want the people you trust to inherit your money, possessions, artwork, books, jewellery or anything else that's meaningful to you, making a will is one of the most important things you can do.
Who would organise your funeral?
Many people assume the people closest to them will naturally be able to organise their funeral. In reality, responsibility usually falls to the executor named in your will, or whoever is legally entitled to administer your estate if there isn't one. You can leave detailed funeral wishes, but they're not legally binding. That's why it's important not only to write your wishes down, but to choose an executor you trust and have conversations with them while you're alive. The paperwork matters, but so do the conversations. Funeral plans can be included in your Statement of Wishes.
Who would have access to your home?
If you were unexpectedly admitted to hospital, who would collect your keys? Feed your pets? Water your plants? Clear out food from the fridge? Collect your post? Look after sentimental belongings? These practical questions are easy to overlook, but they often become urgent very quickly. Thinking about who has access to your home is another important part of understanding your Circle of Care.
What about your digital life?
Much of our lives now exists online. Who knows how to access your phone, computer, password manager, email accounts, photographs, cloud storage or social media? Would you want those accounts memorialised, deleted or passed on to someone else? Making a simple record of important information can make life much easier for the people supporting you. You can read a more detailed guide on planning for your digital legacy here.
And your pets?
For many of us, pets are family. Legally, however, they're treated as property. If you became seriously ill tomorrow, who would collect them? Who would pay for their care? Would they know your wishes? Including pets in your will, or making separate arrangements with someone you trust, can provide peace of mind for both you and the people who care about you. The Statement of Wishes mentioned above is also a great place to leave instructions regarding your pets.
Mapping your Circle of Care
One of the things I encourage people to do is stop thinking from the hetero-normative perspective of having one person to fill every role. Instead, think about your Circle of Care.
Who would you trust to make healthcare decisions? Who would deal with finances? Who would care for your pets? Who understands your funeral wishes? Who has a spare key to your home? Who would know how to access your digital life? These roles don't all have to belong to the same person. In fact, for many of us, they won't. Our lives are often supported by communities rather than individuals. Different people bring different strengths, skills and relationships into our lives, and our planning can reflect that.
Questions to reflect on
As you think about your own Circle of Care, you might ask yourself:
Who knows me best?
Who understands my values?
Who would confidently advocate for me if I couldn't speak for myself?
Who stays calm under pressure?
Is there anyone I wouldn't want making decisions on my behalf?
Have I actually told the people I've chosen?
These aren't simply legal questions. They're relationship questions. Thinking about death and incapacity inevitably leads us back to life: to the people who show up for us, who understand us, who carry our stories and who we'd want beside us when we're at our most vulnerable.
Whether those people are relatives, partners, neighbours, close friends or other chosen family matters far less than whether they're the people you trust. Your Circle of Care already exists. The question is whether the practical and legal arrangements you've made allow those people to care for you in the ways you would want if the unexpected happened.
See the Resource Library for resources to help in your planning. And for a fuller guide to advance planning. click here.
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