Supporting someone who may have decision making problems

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How do I support someone who may have decision making problems?

Mild memory loss and slower thinking can be a normal part of ageing,  however, most older people remain capable of making their own decisions, including managing their own finances and other affairs, throughout life. Sometimes, older people they simply need more time to complete tasks or to ask for help from time to time.

Some people with illnesses like dementia may eventually lose the capacity to manage their own affairs. In these cases an older person may need someone else to be appointed to make certain decisions for them. However, it’s important to be aware that the claim that an older person ‘has dementia’ or has ‘lost decision making capacity’ is often used as an excuse to hide bullying or abuse.

The law says that we have the capacity to make our own decisions unless proven otherwise. This is called having ‘capacity’ or ‘competence’.

How can I tell if someone has the capacity to make their own decisions?

You should assume someone has decision making capacity unless proven otherwise. Proof may include a formal assessment such as a cognitive or neuropsychology assessment.

Lack of capacity is not necessarily an indicator of dementia. A person’s capacity can be temporarily affected by stress, anxiety, medication, illness, infection or injury, and then regained after a temporary illness or stressful situation passes.

Decision making capacity can vary depending on the issue being decided. For example, it may be difficult for a person to understand complex banking arrangements, but they may be quite capable of deciding things such as medical treatment or where they want to live.

If there is any question about someone’s capacity to make decisions, discuss getting an assessment with the older person themselves or contact the Office of the Public Advocate for further advice.

How does assessment for capacity work?

An assessment for capacity needs to be undertaken by a trained medical professional. The best place to start is with a GP, a Cognitive Dementia and Memory Service (CDAMS) or an Aged Care Assessment Service (ACAS).

If the person refuses to be assessed and there is concern for their safety, contact Office of the Public Advocate for advice.

More information

Interagency Guideline for Addressing Violence, Neglect & Abuse (IGUANA) is a good practice guideline from the Office of the Public Advocate.

What are powers of attorney?

A Power of Attorney are legal documents that let you choose someone who can make decisions for you about things like your financial, lifestyle of medical affairs. There are different types of Powers of Attorney and different documents apply to each. The law requires that the person making the powers must be able to understand what they are doing and act of their own free will.

Abuses of Powers of Attorney are one of the ways that elder abuse occurs. Seniors Rights Victoria recommends that a lawyer be used to draw up Powers of Attorney. Contact Seniors Rights Victoria or Office of the Public Advocate for more information.

Fact sheets, forms and guides to making powers of attorney are available from the Office of the Public Advocate and from Victoria Legal Aid.

Acknowledgment

Some content on this page has been drawn from With Respect to Age 2009 and Elder Abuse Prevention Strategy Workshop Manual 1.

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