The reality of dementia
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Dementia is now the leading cause of death in the UK, and with an ageing population, the disease is on track to become an increasingly significant issue for society.
The statistics make for grim reading, let alone reality, and so it is now more important than ever that we take steps to understand how the disease impacts a person's decision-making ability.
There is a common misconception that a diagnosis of dementia means a person is automatically unable to make valid decisions about property, finances, health or welfare, but in many cases, this may not be the case.
Dementia can affect a person’s ability to make decisions because it can affect the parts of the brain involved in remembering, understanding and processing information. However, because the disease is progressive, it is likely that a person’s capacity will reduce over time, and the rate and the extent to which this happens will depend on the individual and the type of dementia they have.
For an individual to make valid decisions about their finances, property, health or welfare, they must have the requisite mental capacity. There are different tests and thresholds of capacity for different types of decision (e.g. to marry/enter a civil partnership, to write a will, to appoint an attorney, etc.), and many may be surprised to learn that as the law stands the threshold for capacity to marry is lower than that required to write a will.
It is also important to understand that mental capacity is time and decision specific, and so it may be that a person will have lucid intervals when decisions can be made.
The Mental Capacity Act 2005 provides a legislative framework designed to protect people who have mental capacity issues but also to enable them to make decisions for themselves for as long as possible. People with dementia should certainly be supported in making their own decisions about their care and day-to-day lives for as long as possible, but with more significant decisions care must be taken.
Assessing whether someone has the requisite mental capacity to make a particular decision is rarely if ever likely to be straightforward. Specialist medical and legal advice should be sought, and best practice followed.
