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Q: Explain why the ability of an individual with dementia to make decisions may fluctuate
A: The nature of dementia as a progressive illness means that the mental capacity of someone with dementia is likely to change over time. [ [ As a person progresses through their dementia, their capacity to understand the issue and to make a decision based on their ability to reason lessens. Following the principles of the Mental Capacity Act 2005 advocates start working with a person with dementia
with the assumption that they do have mental capacity. People with dementia especially in the early stages are often able to understand the issues and retain relevant information if they are given time and information in a manageable and appropriate format i.e using simple language to explain something more complex or presenting it in a visual format. However, even people in the middle to late stages of dementia will have a level of mental capacity which will enable them to be involved in making some decisions. Mental capacity in someone with dementia may also fluctuate from day to day and visit to visit. The advocate therefore needs to be flexible and innovative in their approach. In these situations the advocate cannot always take the first response to a question. The advocate will need to revisit conversations, asking the same questions at different times and in different ways to establish consistency in the client's feelings and expression. The advocate needs to be as sure as possible that they have understood the person's wishes or views. The level of insight the person has into their own situation and abilities is also likely to be affected and will diminish with time. This can often present a challenge for the advocate - representing the wishes of a client who has no insight into their needs, is living in a different reality and is unable to understand the risks of some decisions. The advocate has the dilemma of acknowledging the reality of the person and the feelings and wishes attached to that and being truthful in order to find a solution to the issue that best meets the needs of the person. ] ]
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Asked 3/18/2013 2:47:42 PM
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