It was an honour for Michael Perkins and Dr Jane Lonie, co-founders of the firm, to present at this conference some of the lessons learned in establishing the Capacity and Capability Clinic, initially at Macquarie University Hospital and now also through the normal operations of Autonomy First Lawyers.

The slides that supported the presentation are here. Please contact us if you want to discuss any of the points made in this presentation or this article.

Michael Perkins attended both days of the conference and three lessons he learned are:


1. We need to think more broadly about how care planning needs to work in non-medical settings.

A working definition of non-medical advance care planning has been settled by Michael and is in use in the firm:

“Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, will and preferences regarding the delivery of their future care across all settings in which the person lives.

The goal is to help ensure that people receive care (support and assistance) that is consistent with their values, goals, will and preferences during their life in line consistent with the National Decision Making Principles.”

(Definition Adapted from Sudore, R.L. (2017). Journal of Pain and Symptom Management, 53(5): 821:832)

See also .

It is our purpose to help all our clients achieve these outcomes in the management of their affairs.


2. Small Changes matter!

a. Delay in responding to changes in cognition and decision making ability can, if dementia is involved, delay the ultimate diagnosis by 3-5 years on average. Research teaches us that for every dementia diagnosis there have been between one and three DECADES of decline.

b. We are committed to practicing the National Decision Making Principles and using our Estate Planning and Administration services as an opportunity to intervene early in the ageing process, so we can (if our clients agree) help mitigate the risk of abusive or coercive conduct emerging in the affairs of a person by encouraging collaborative and cognitive responsive communication styles in the operation of the affairs of the person, family and supporters.


3. There are insufficient deployment standards about what matters most in dementia-specific care planning in a domestic setting.

The best advice we can source proposes that the following principles be followed in establishing dementia-specific care planning:

a. Core Dementia Responsive Environment Principles:

Principle 1: Unobtrusively reduce risks
Principle 2: Provide a human scale
Principle 3: Allow people to see and be seen
Principle 4: Reduce unhelpful stimulation
Principle 5: Optimise helpful stimulation
Principle 6: Support movement and engagement
Principle 7: Create a familiar space
Principle 8: Provide opportunities to be alone or with others
Principle 9: Provide links to the community
Principle 10: Respond to a vision for a way of life

b. How these principles should be applied in particular contexts remains a work in progress.

How these issues affect people are infinitely various. For an outline of the consultation approach that we use in helping clients navigate the complex issues around the ageing of themselves, their family or other loved ones, click here.

Contact us if you would like to discuss further how these issues affect your life or objectives.