As our society ages, the care of our elderly loved ones becomes an increasingly important and pressing matter. Providing quality care for the elderly is not just a duty; it’s an expression of love, respect, and gratitude for the wisdom and experience they bring to our lives. In this blog, we will explore practical ways to ensure they live their golden years with dignity and comfort.
Falls are a common cause of injuries among the elderly. Ensure their living space is free from hazards, such as loose rugs or clutter, and consider installing handrails and grab bars as needed.
Adapting the home environment to their needs is essential. Consider installing ramps, non-slip flooring, and making doorways wider for easy access.
Make sure that the home is wheelchair or walker-friendly. This includes widening hallways and doorways and ensuring that countertops and appliances are at accessible heights.
Respect their need for personal space and independence whilst assisting when necessary. Discuss with them how they want their living space to be arranged and accessible.
Dementia can have a profound impact on a person’s cognitive abilities, making it difficult to determine their capacity to make decisions. In this article, we explore the challenges of assessing mental capacity in people with dementia and offer helpful tips for navigating this complex process.
Mental capacity refers to an individual’s ability to make informed decisions. It is crucial to assess mental capacity, especially when a person’s decision-making ability is in question due to cognitive impairments such as dementia. The assessment process involves evaluating various factors to ensure that the person has the necessary capacity to make a particular decision.
Factors to Consider in Assessing Mental Capacity
When evaluating mental capacity in people with dementia, several factors must be taken into account:
The person’s age and overall health: The individual’s age and health can influence their cognitive abilities.
The stage of their dementia: The severity of dementia can impact the person’s capacity to make decisions.
The nature of the decision that needs to be made: Different decisions require different levels of cognitive abilities.
The person’s ability to understand the information relevant to the decision: Can they comprehend the necessary information?
The person’s ability to weigh the pros and cons of the decision: Are they able to analyze the consequences of their choices?
The person’s ability to communicate their decision: Can they effectively convey their preferences?
Tips for Working with People with Dementia
Here are some practical tips to keep in mind when working with people with dementia during the mental capacity assessment process:
Be patient: Dementia can slow down information processing, so give them time.
Use clear and simple language: Avoid technical terms and jargon that may be confusing.
Repeat yourself as needed: People with dementia may forget what you have said.
Use visual aids: Pictures, diagrams, and other visual aids can help convey information.
Encourage participation: Involve the person in the decision-making process as much as possible.
Get input from family and friends: Consult with those close to the person for insights on their abilities and preferences.
Seeking Professional Help
If you have concerns about a person’s mental capacity or need guidance on how to proceed, it’s essential to seek professional help. You can contact Victoria at 07734393918 for assistance and to have your questions answered. Remember, seeking expert advice is the best way to ensure a thorough and accurate assessment of mental capacity in people with dementia.
In this Gain Capacity Case Study, Victoria was approached by a solicitor who urgently required a capacity assessment for litigation within 10 days. Using the Dunhill v Burgin case as a guide, Victoria conducted a comprehensive assessment of the client’s capacity to litigate. Despite the client’s articulation and vocabulary, she displayed confusion and a lack of understanding and insight into her case. Victoria concluded that the client lacked the capacity to litigate and promptly provided feedback and a detailed report to the solicitor. This allowed the legal team to take appropriate action to protect their client’s interests and ensure a fair legal process. This case study emphasises the importance of timely and thorough capacity assessments in facilitating informed decision-making and effective participation in legal proceedings.
Challenge:Victoria was contacted by a solicitor who needed an urgent capacity assessment to determine whether their client had the capacity to litigate. Victoria had to provide a quote and complete the assessment within 10 days as the report was required before the court hearing in 14 days.
Solution:Victoria arranged to meet with the client to determine her capacity to litigate. The solicitor had noted inconsistencies in the client’s instructions and behavior, which raised concerns about her capacity. Victoria used the Supreme Court’s post-MCA case of Dunhill v Burgin as a guide to assess whether the client had the capacity to conduct the proceedings, give proper instructions, and approve a compromise.
During the assessment, Victoria found the client to be frail and confused about the current issues related to the court case. Despite being articulate with a wide vocabulary, the client lacked insight and understanding of the case. She was also inconsistent with her answers and had difficulty retaining information. Based on the assessment, Victoria concluded that the client lacked the capacity to litigate.
Victoria provided verbal feedback to the solicitor, and the report was delivered within two days of the assessment interview.
Results:Victoria’s timely and thorough assessment provided the solicitor with the information needed to make informed decisions about their client’s ability to conduct litigation. The report allowed the solicitor to take appropriate steps to protect their client’s interests and ensure a fair and just legal process. The solicitor was satisfied with the results and provided positive feedback to Victoria.
Key Takeaways: In this case study, Victoria was contacted by a solicitor who needed an assessment to determine if their client had the capacity to litigate. The report was required within 10 days as they were due back in court within the next 14 days. Victoria arranged to see the client who was experiencing confusion and lacked insight and understanding of the current issues. The assessment concluded that the client lacked the capacity to litigate. Victoria used the relevant case study as a guide to decide whether someone can conduct proceedings and manage the litigation. She provided verbal feedback to the solicitor and he received the report within two days of the assessment interview. This case study highlights the importance of assessing a client’s capacity to litigate in order to ensure they can make informed decisions and participate effectively in legal proceedings.
Victoria Sample was contacted by the daughter of a woman, whom we will call Mrs. B, who had been diagnosed with dementia and had recently been placed in a care home. The daughter was unable to access her mother’s bank account, manage her mother’s home, or pay bills, leading to a debt in care fees.
Challenge: Mrs. B’s daughter was unable to manage her mother’s finances due to her lack of access to her mother’s bank account, as well as her own inability to decide whether to sell her mother’s home to raise funds to pay the care fees. Mrs. B’s daughter was also unable to manage her mother’s home, pay bills, or make necessary calls.
Solution: The solicitor recommended Victoria Sample to do a mental capacity assessment on Mrs. B with a view to either apply for a Lasting Power of Attorney or make an application to the Court of Protection. Victoria spent an hour with Mrs. B at the care home, speaking with the care staff and reading through available medical and nursing notes. Victoria found that Mrs. B lacked the capacity to manage her finances due to advancing dementia.
Results: The solicitor received the report and COP3 assessment form the following day. Victoria’s assessment allowed for the application of a Lasting Power of Attorney or an application to the Court of Protection, which helped Mrs. B’s daughter manage her mother’s finances and pay the outstanding care fees.
Key Takeaways: This case study demonstrates how dementia can impact a person’s ability to manage their finances and how a mental capacity assessment can help families manage care costs for their loved ones with dementia. It also highlights the importance of having a Lasting Power of Attorney or an application to the Court of Protection in place to manage the finances of individuals who have lost mental capacity due to conditions such as dementia.
How to assess mental capacity and what to do if someone does not want to engage with the assessment
I attended a webinar withNelson’sSolicitors this week. We decided that I would comment on the following questions
When capacity to make a specific decision is in issue, how do you test P?
When P is unwilling to communicate, what strategies do you have to try and break the deadlock?
As you can see in the image (see link here Scan post it notes ) I had lots of notes and planned my response.
What does P mean?
Firstly let me explain, in legal terms the ‘P’ stands for person in question or person being assessed.
Mental Capacity Assessment process
When doing a mental capacity assessment it is important to establish whether there is an impairment or problem with the brain, which may affect their ability to make decisions, such as dementia or brain injury. We also consider the history of the person and their current circumstances.
With the particular decision (for example financial decisions) we need to establish whether the person can:
UNDERSTAND: We check understanding by asking a number of questions related to the matter. Such as where do you work? Sources of income, details of any debt, what bills do you have? Where do you bank? I also show most people objects to establish is they understand their uses. Such as money, till receipts, or a purse.
We check whether they can retain information throughout the assessment by providing information and check understanding and memory. I ask questions to check long and short term memory, as well as asking if they have noticed any problems themselves. I sometimes administer specific cognitive testing such as the Addenbrook’s Cognitive Examination (see link here) https://neurovascularmedicine.com/ace.pdf
WEIGH OR USE INFORMATION
This is more tricky to assess as people can often understand but cannot use this information to make an informed decision. I would always check how people use information by asking other people how they manage information in real time. Consider how much support someone requires, whether they are in any debt or have problems managing themselves. This part of the assessment involves establishing whether there is evidence that a person can comprehend and rationalise information to make a decision.
Being able to reliably communicate a decision by any means is important. I have known people to use sign language, and writing information down.
What to do if someone does not want to engage in assessment
To answer the question, to describe what I do when someone does not want to be assessed. Firstly I try to gather as much information as I can before the assessment date, I aways try to build rapport as soon as possible by reading body language and ensure they feel listened to. I tend to approach every assessment differently depending on the person’s circumstances, but I always give respect and space, I do not behave or act as an expert.I am always interested in their life and ask inquisitive questions. If the person does not want to engage, I will leave it and arrange to meet another day, and consider the location, environment and time of day.
I have added the link for a previous blog on working with vulnerable and young people
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