Ability to make one’s decisions is essential to individual autonomy. If ever a person loses their ability to understand choices and repercussions, that is when they begin to need help making decisions. You may find yourself having to make choices for a parent or spouse.
Seniors with diminished mental capacity may not be in a position to make their own decisions. However, they can still know what they want and express it. Not having the capacity to make sound decisions is based in ability to understand and evaluate options and predict repercussions. It does not mean that a person doesn’t know what they want.
When deciding for a senior loved one with declining mental capacity, you should always try to strike a balance between acting in the patient’s favor and respecting his or her autonomy. The following practices can help you do that.
The first thing to do is to have your aging loved one assessed professionally by a clinician. The specialist’s job is to determine whether the individual has the capacity to make sound decisions. If it’s found that they understand and make their own decisions, then always allow them to make their own decisions.
Act in Their Best Interests
This may include alleviating the patient’s anxiety, taking time to educate the individual and their family, considering lucid intervals and the person’s physical conditions like difficulty in speech, which can sometimes interfere with capacity. Doing so is the only way to act in the best interest of the senior with diminishing mental capacity.
Disclosure of Diagnosis
In the past it was an accepted practice for doctors not to speak directly to their patients about deteriorating mental capacity. That has now changed. Today, it’s considered a patient’s right to be informed about their health condition and treatment discussions. So, involve the patient and disclose to him or her results of diagnosis. When you’ve assessed diminishing mental capacity and found out that the patient has dementia, it is good to let the patient know of their condition. Especially when it is still at its early stages. In other words, the stage of the mental illness and the time of diagnosis should be considered.
As mental illness progresses, competency and decision-making capacity will definitely be affected, and this may make the patient’s ability to fully understand the diagnosis as well as its implications could be limited. When it the mental illness is at its advanced stage, there may be no need to disclose the diagnosis to the patient because they might not even care. This means that the disclosure would actually be futile.
Don’t assume that you should make all the decisions alone for seniors with diminishing mental capacity. Always involve them whenever possible. You should also ensure that you always act in their best interest when you are deciding anything for them.