Losing the ability to make informed decisions, known as a loss of capacity, can happen to any of us, particularly as we age. This guide explores what capacity is, why it’s essential to our daily lives, and how it can be affected by various health conditions. By understanding the causes and implications of losing capacity, you can take proactive steps to safeguard your elderly parents’ future, ensuring that their wishes are respected even if they are unable to make decisions for themselves.
What is capacity?
Capacity is the term used to describe the ability to make and communicate informed decisions.
This ability is something which we tend to take for granted although it is something we rely on throughout our everyday lives. For example, you are using your capacity when you get up each day and decide what to wear, whenever you go shopping and decide to buy something, or when you are sent a bill for something and decide whether, how and when to pay it.
Your capacity can vary depending on the situation and the level of information and judgement required. After all, deciding between ice cream or cheese for dessert requires a different level of capacity than consenting to undergo a potentially life threatening medical procedure.
Timing and setting can make a difference to your capacity too – you might find it easier to make important decisions when you’re feeling well rather than when you’re recovering from a nasty bout of flu, or in the midst of a stressful period at work or whilst running for a bus.
The importance of mental capacity
The ability to understand and weigh up information is essential for you to stay in control of your life, your health, home, finances etc. Your level of capacity affects your ability to live independently, to cope with the various stresses and strains of everyday life, and to plan and manage your home, finances, healthcare and other affairs.
Without capacity, you might need help with everyday tasks like eating, drinking, sleeping, bathing or dressing, or be vulnerable to being scammed or exploited.
How do people lose capacity?
It is possible to lose your ability to make some decisions whenever your brain function is impaired or injured in some way. This impairment can be temporary or permanent.
Examples of temporary loss might be the effects of acute alcohol poisoning, a psychotic episode or a prolonged period of major depression (https://carents.co.uk/depression-2/). More permanent loss can occur after a severe road accident causing a severe head and brain injury. Depending on its severity, a brain infection such as meningitis can cause temporary or permanent loss of capacity.
Other common conditions which affect capacity tend to be more likely in later life which is why it is so important for carents to understand capacity and help their parents plan for any loss.
Common conditions affecting capacity in older adults
- Delirium – this condition is more common in older people and can occur after a simple trigger such as a urine or chest infection, medicine, hospital stay or simply dehydration or constipation. This condition is reversible but often causes a temporary loss of capacity – read more about delirium in older people
- Dementia – dementia is the umbrella term for different types of progressive brain diseases leading to declining levels of capacity – read more about dementia
- Stroke – a stroke can damage parts of the brain and depending on the severity and location of the stroke, it can lead to temporary or permanent loss of capacity. Read more about strokes
- Falls – falls and other accidents can cause head injuries which can affect capacity. Read more about falls
- Side effects of medicines – some medicines can cause confusion or drowsiness with a temporary impact on capacity. Read more about medication
- Tumors – Brain tumors can physically disrupt brain function leading to loss of cognitive abilities
- Mild cognitive impairment – some of us can naturally experience a degree of age-related decline in our brain function. This tends to be relatively mild but it can affect our capacity to make complex decisions.
Steps You Can Take to Prepare
None of us know what the future holds, but you can make plans which can help you to retain some control over your life even if you lose capacity. Common steps include:
- Create lasting powers of attorney – legal arrangements which allow you to appoint someone you trust to make decisions on your behalf. Read more about LPOAs
- Create advance decisions (Living Wills) and statements – living wills and advance statements allow you to outline your wishes regarding medical treatment in case you lose the capacity to communicate them. This might entail specifying treatments you do or do not want, such as resuscitation or life-sustaining procedures. The law relating to living wills varies between countries within the UK. Get information about DNAR/DNR orders
- Discuss Your Plans with Loved Ones – having open conversations about your wishes can help prevent misunderstandings and ensure that everyone knows your future preferences and can feel comfortable about honouring your preferences.
Created August 2024
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