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How to Communicate with People Who Have Dementia Part 6

Determine “Who makes the decision?”

 Health-care decisions should be made by the agent appointed in an advance directive or medical durable power of attorney. In some States you may need to have a mental health power of attorney. Please check with the Attorney Generals office in your State for the proper legal documents that are required. If the individual with dementia hasn’t completed these documents, decisions may be made by a health-care proxy. This is an individual whom the family and other interested parties agree upon to be the decision maker. While not all states have health-care proxy laws, when families are in agreement, health-care providers usually rely on the family-appointed decision maker, or rely on the family to come to a consensus. If irresolvable conflict exists, the decisions of the court-appointed guardian or conservator prevail.

Guidelines on making decisions for incapacitated persons       

  • Identify and set aside your biases and values that are inconsistent with the known beliefs of the person with dementia.
  • Learn all you can about the individual’s history and past preferences. Ask other family members, friends, and colleagues what they know to be true for the person.
  • Recall past conversations. Write them down to refer to when needed. For example, if a parent has said, “I don’t want you spending your life caring for me,” this may be his or her way of letting you know that living in a nursing home is a viable option.
  • Remember to act as a proxy decision maker. Make the decision as if you were the person making the decision. While the decision may conflict with what you would do for yourself, your responsibility is to act in accordance with the known beliefs and values of the individual with dementia.

Remember . . .

  Believing that individuals with dementia have much to offer is the key to bestowing a status of personhood upon them. Additionally, good communication skills deepen the respect for and social engagement of those living with dementia. Most importantly, relax, enjoy, be present, and laugh with the cognitively impaired. Rewarding relationships and trust will quickly follow.

 www.blessingsforseniors.com

Jack Coito

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