Planning: minimal capacity

Helping someone with minimal capacity

You may be caring for someone who has lost capacity suddenly as a result of an accident or an acute illness. Alternatively, it might be someone who has lost capacity gradually from a progressive illness such as dementia.

How decisions are made by, and for, this person will not always be clear-cut. They should continue to have as much input to decisions as is possible, given their individual circumstances. However it may get to a point where they do not have the capacity to do this and you will have to make decisions for them.

Approaches to decision-making

When making decisions for another person:

  • The first approach should be to consult any written directives or clear statements that the person has made previously. These need to be reviewed to check if they apply to the current situation and whether there is any reason to believe the person may have changed their mind since writing the directive.
  • The second approach is to use substituted judgement – basing your decision on what you believe the person would have chosen. This works best if there has been discussion or some written guidance from the person about their wishes.
  • If it is not clear what the person would have chosen, the third approach is to make decisions based on their best interest – weighing up all the information about the situation, including what might be known of the person’s wishes.

Select a scenario that's similar to your situation:

My cousin has dementia and has ended up in hospital needing an operation. But I am not sure who needs to give consent for the operation to go ahead.

Read more

Although mum cannot speak for herself, she does have an advance care directive; it’s just that family members are finding it hard to agree with following it through.

Read more

Dad can’t answer the doctors’ questions properly but I think he still should be involved in the decisions about his treatment somehow. What can we do?

Read more

I have to decide if my auntie goes into a hostel and I have never discussed this with her, so I don’t know what to do.

Read more

My wife is in a nursing home and can no longer make her own decisions. While she is stable at the moment, is it possible for me to plan ahead for what might happen in the future?

Read more

My husband has dementia as well as some other serious medical problems and the doctors want to operate, but I don’t know if that is what he would want. I don’t know my rights when I talk to the doctors.

Read more

I saw an advertisement for people with dementia to take part in a research project. Should I suggest this for my wife, who has dementia? How should I decide whether or not to give my permission?

Read more

My mum has dementia and the doctor looking after her asked us how we would feel about donating mum’s brain to research after she dies. Mum cannot decide for herself any more and I don’t know what she would want. I feel too overwhelmed to think about it.

Read more