What happens when someone has capacity but can't physically sign

"He can't hold a pen. He understands everything. He nods when I ask him questions. He squeezes my hand. But he can't sign."

This is one of the harder calls we take.

The man in question had Parkinson's. Late stage. His mind was completely intact — sharp, even — but his hands had stopped cooperating. His daughter had already tried two other providers. Both had told her they couldn't help. Not because he lacked capacity. He had full capacity. He just couldn't physically hold a pen.

She assumed that meant the door was shut.

It isn't. But we understand entirely why she thought it was.

What the law actually allows

The Mental Capacity Act 2005 and the regulations that govern Lasting Power of Attorney forms are more flexible than most people realise, and more flexible than most providers are willing to deal with.

If someone has mental capacity but can't physically sign, there are two main legal routes available.

The first is called signing by direction. The donor — that's the person making the Lasting Power of Attorney — can direct another person to sign the document on their behalf. The donor needs to be present, watching, and clearly giving the instruction. Another person then signs the form, and the documentation records exactly what happened and why. The law permits this explicitly. It is not a workaround or a grey area.

The second route is a mark. Some people who cannot form a full signature can still make an intentional mark — a cross, an X, a deliberate line. Provided the mark is intentional and properly witnessed, it can legally stand in place of a signature.

Neither of these options is obscure. Both are written into the LPA regulations. The problem is that most providers have built their entire process around the assumption that everyone can simply pick up a pen. When that assumption breaks down, the process breaks down with it. It is easier for them to say "we can't help" than to build a pathway for the exception.

We have built that pathway.

What signing by direction looks like in practice

It helps to walk through this concretely, because families need to understand the mechanics before they can prepare for them.

The donor must be present. This is non-negotiable. The signature cannot be given in their absence, whether that absence is physical or mental. They need to be in the room or, in many cases, visible on a video call. And they need to demonstrate that they are giving the direction — instructing the other person to sign.

If the donor can speak, a verbal instruction is straightforward. If they can't speak clearly, the direction can be given through a nod, a hand squeeze, a gesture — but when this happens, the witnesses need to write down immediately what they saw. Specifically: that they witnessed the donor give a clear indication of their wish to proceed, the time at which they gave it, and what form that indication took.

Two witnesses are required. One witnesses the signature made on the donor's behalf. One witnesses the Certificate Provider section of the form. These cannot be the same person.

If someone has capacity but can't sign, that doesn't make the Lasting Power of Attorney impossible. It means the process needs more care, more witnesses, and more documentation. That's what we're here for.

The person who signs on the donor's behalf cannot be one of the attorneys named in the Lasting Power of Attorney. They also cannot be the Certificate Provider. In most cases it's a family member — a spouse, a sibling, another adult child — who was already going to be present anyway.

The document itself must record what happened. Not in complex legal language. A clear, factual note in the correct section: the donor directed a third party to sign on their behalf, who that person was, and why the donor was unable to sign directly.

What families need to prepare

When we work through a case like this, we ask families to think carefully about three things before we begin.

First: who is going to be in the room? They need to identify someone who can physically sign — someone who is not one of the attorneys, and not the Certificate Provider. Usually a family member already involved in the care situation. Getting this right before the day means no last-minute complications.

Second: how is the donor going to demonstrate their direction? If they can speak, that's straightforward. If not, the family needs to agree in advance on the signal they'll use and how they'll document it. A squeeze of the hand, a nod, a gesture. Whatever it is, it needs to be unambiguous, and someone needs to write it down at the time — not from memory later.

Third: the Certificate Provider needs to be sorted, and sorted carefully. In cases with any complexity around signing, the Certificate Provider's role carries more weight, not less. Their job is to confirm that the donor understands the document and is choosing it freely. In a case where the donor can't speak or sign clearly, the Certificate Provider needs to be someone who has done this before — someone comfortable asking direct questions, reading non-verbal responses, and documenting what they observed.

We act as Certificate Provider in these cases. It's a video call. One of our planners speaks directly with the donor. We explain what the document does, in plain terms. We ask whether they understand the Lasting Power of Attorney and what it will allow their attorneys to do. We ask whether anyone has pressured them. We watch the responses carefully, and we document everything. If we are satisfied, we sign. If we are not satisfied, we say so clearly and explain what the next step should be.

Why most providers won't touch this

We'll be straight about it: signing by direction adds steps. It adds witnesses. It adds documentation requirements that go beyond a standard application. If any of those steps are done incorrectly — wrong witnesses, no recorded direction, missing details — the Office of the Public Guardian will reject the application on arrival.

Providers whose process is built on a form-fill system or an automated template cannot handle the variation. A human has to manage this. A qualified person has to read the case, identify the issue, walk the family through the mechanics, check the documentation, and take responsibility for the outcome.

That's what we do. Every Lasting Power of Attorney we handle is drafted and reviewed by a qualified person, not a system. That's what makes cases like this possible.

The door is not shut. It just requires the right person to help you open it.