As we grow older, we are often faced with making a range of important life decisions, such as where we should live, what support we need, and who should help us manage our finances and our health?
Sometimes family members have different ideas about these important life decisions. This can give rise to conflict and disagreement within families. Disagreements often stem from, or are exacerbated by, differing perspectives about the extent of a person’s decision making ability.
Remaining involved in decisions that concern you
It is always important to ensure that the person to whom the decisions relate, remains involved. This can become harder as we age, particularly when medical conditions are present that impact on brain function and decision making ability.
“When a person has experienced some memory loss or cognitive decline, it can become more difficult for them to make important life decisions on their own”
When a person has experienced some memory loss or cognitive decline, it can become more difficult for them to make important life decisions on their own, particularly where the decision is a complex one and many factors need to be taken into account.
It is therefore important for decision makers and their families/supporters to understand;
- When a person is capable of making a decision independently;
- When a person is reliant upon the support of one or more others to do so; and
- When a decision needs to be made by another person on behalf of an individual
The appropriateness of the options outlined above is a function of both the complexity of the decision that needs to be made and the extent of a person’s decision-making capabilities.
Working with a Clinical Neuropsychologist
Clinical Neuropsychologists have expertise in evaluating brain function and decision making capacity to determine the appropriate level(s) of support (if any) that are required for an individual to engage with and make a decision about one or more important life matters and what type of support is required for an individual to remain engaged with and involved in decisions about themselves.
When the family unit retains a collective understanding of how and on what levels the central decision maker is able and/or unable to engage with the decision making process, accommodations can be put in place to maximise their ability to contribute and to provide the decision maker with the appropriate levels of support to engage or to represented by the preferred persons.
This concept is referred to as ‘supported decision making’. It is an important and preferred process (to that of substitute decision making) in cases where there has been a partial loss of decision making autonomy.
Do you need help with supported decision making?
If you think that you, a family member or a client may need help with supported decision making, please contact us. We are happy to discuss what your next steps might be. And yes, we do house calls.
Dr Jane Lonie is a consultant clinical neuropsychologist, expert witness, author and educator with 20 years’ experience in the assessment, management and research of cognitive dysfunction in adults.