ABSTRACT
This chapter emphasizes the importance of changes in decision-making capacity to a person living with dementia and the ways in which this, or its effects, can potentially be reduced. The potential impact of dementia on decision-making capacity is explored, predominantly through the use of clinical case descriptions. Dependent on the person’s circumstances, illness factors and the stance taken by others involved, there may be a shift from the presumption of capacity to the need for an assessment or even an unjustified presumption of a general lack of decision-making capacity. Any improvement in capacity may only be apparent some weeks after an underlying cause is treated. Urgent decisions will need to be taken on a person’s behalf if he lacks capacity due to a temporary cause. A particular cognitive change can only produce a loss of decision-making capacity when combined with an individual’s specific situation.
