There is a choice. There is no requirement for someone to make a lasting power of attorney. If they wish they may decide not to make one and let the stranger, their doctor, the social worker or the court they may have never met make decisions for them. It's really their choice.
Making an LPA may be considered by some as comparable to obtaining a passport, buying personal insurance or making a will. It is likely that a person’s mental capacity will deteriorate with age, and may not in the future be sufﬁcient to make vital or even everyday decisions regarding their health, welfare, ﬁnances and property. Should a person lack mental capacity in the future and not have the protection of an LPA, these decisions could be taken by a court appointed Deputy.
An LPA allows the donor, who may in the future lose mental capacity to make decisions, to instruct a donee or attorney (person granted authority) to make decisions on their behalf. An attorney acting under an LPA may be granted the power to make both ﬁnancial and welfare decisions. The donor may speciﬁcally indicate what powers they wish the attorney to have and place restrictions on the use of these powers. The donor may also provide guidance as to how they would wish the LPA to be managed generally or speciﬁcally. The donor could appoint more than one attorney to manage different aspects of their affairs or appoint both a welfare attorney and a financial attorney to work in partnership with each other.
It's about have that choice to appoint someone who knows the donor well and can promote the donor's autonomy.