Mental capacity is task specific so someone may have capacity to make a decision about one area of their life but not another. People often call Pathways Through Dementia to find out how exactly we assess someone’s capacity: the legal test for capacity involves passing all of the following 4 steps,  someone has to be able to
  1. Understand the information being presented to them
  2. Weigh up the pros and cons of the decision being made
  3. Retain the information for as long as is necessary to make the decision
  4. Communicate their decision
What is also helpful to know is who ultimately decides whether an adult with memory problems is able to make the decision they are faced with, here are some examples.
  1. Getting married/entering a civil partnership – the person conducting the ceremony is charged with assessing an individual’s capacity to understand the consequences of the contract they are entering into
  2. Driving – a driving assessment and/or the DVLA makes the determination as to someone’s driving skills
  3. Drawing up a Lasting Power of Attorney – the Certificate Provider on the day decides whether, legally, the donor can sign the forms and understands the future implications of doing so
  4. Healthcare options – a doctor, nurse or consultant would assess whether their patient has mental capacity to consent to treatment/deny themselves treatment. An attorney/Deputy for Health and Care would lend weight to the final decision

Make, register or end a lasting power of attorney: Overview – GOV.UK (www.gov.uk)

Deputies: make decisions for someone who lacks capacity: Overview – GOV.UK (www.gov.uk)

Weighing up the pros and cons of a decision is often the step where people with dementia struggle: someone might be able to oppose the idea of homecare, for example, but they cannot explain their reasoning/their reasoning is not based in reality. Equally however, if someone is deemed to have mental capacity they are allowed to make an ‘unwise decision’ so if they could communicate that it means  they fully understand the risks attached to rejecting a package of care at home and they could return home without that support package in place.
For more information or to ask a question about mental capacity call us on 0203 405 5940/admin@pathwaysthroughdementia.org