Written by Active Minds on Wednesday the 11th of September 2019.
As someone progresses along their dementia journey, they may become less capable in making some decisions for themselves. As this happens, the person may be described as lacking ‘capacity’. In England and Wales, there is a law which protects those in situations such as this; the ‘Mental Capacity Act’. This law covers such things as important decision making in regard to a person’s property, finances, health and social care. It can also cover other things such as personal care, nutrition and clothing.
What is Mental Capacity
Mental capacity refers to the ability to make decisions for one’s self; everyone has capacity unless proven otherwise. So it should be assumed that a person living with dementia has capacity until there is evidence against this; the Mental Capacity Act provides guidelines on determining whether someone has capacity to make decisions for themselves, as it may not always be a clear and easy decision.
The Mental Capacity Act details two main points that should be considered when deciding whether an individual is able to make decisions for themselves. There first must be a reason why the persons ability to make decisions is affected; dementia can be one of those reasons.
The next consideration to make is based on their ability to make and communicate decisions. If an individual is unable to make a specific decision under consideration and unable to understand, remember and weigh up necessary information it can be deemed they don’t have the capacity to make decisions for themselves. They must also be able to communicate their decision, whether through words, gestures or facial expressions. There are a number of people who could be expected to have to make a judgement on someone’s mental capacity. From care workers and doctors to family members and social workers.
When making decisions for an individual who does not have the capacity to make their own, they must be made in their best interest. There are some questions you can ask yourself to determine whether the decision being made is in the person living with dementia’s best interest.
First of all, it is important to consider whether the individual will be able to make the decision at a later date and whether the decision can wait until then. This can sometimes be the case when someone is recovering from an operation. Consider whether there are ways you can include them in the decision making; maybe by using prompts or pictures. Think about what the person would want if they knew someone was making a decision for them; who would they want to make it? You also need to take into account the individuals personal and religious beliefs, this may be able to help guide your decision making. It is also advisable to consult with others such as family and friends during decision making.
Who Makes The Decisions?
The Mental Capacity Act allows those living with dementia to plan ahead. In order to have more control over decision making in the future, a person living with dementia can choose a person, or multiple people, to have lasting power of attorney; someone who has the authority to make decisions on the person’s behalf when they no longer can.
In general, there are a number of people who will make decisions on behalf of someone who does not have the capacity to do so; it will usually be family members, doctors and care workers.