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Understanding capacity and decision-making issues in dementia care
Phil Joddrell1,2, Edward Lee3, Katrina Vollentine3
1Research and Publications, Dementia UK, London, England, UK.
British Journal of Community Nursing
|December 8, 2025
Summary
Supporting dementia patients in decision-making is crucial. This article examines the Mental Capacity Act 2006, emphasizing shared decision-making and person-centered care for community nurses.
Area of Science:
- Gerontology
- Bioethics
- Health Law
Background:
- Global rise in dementia prevalence necessitates enhanced support for patient autonomy.
- Decision-making capacity in dementia is a complex legal, ethical, and practical challenge.
- Community nurses play a vital role in supporting individuals with dementia.
Purpose of the Study:
- To explore legal, ethical, and practical aspects of decision-making capacity in dementia.
- To examine the application of the Mental Capacity Act 2006 in England and Wales.
- To provide guidance for community nurses on compassionate, lawful, and inclusive care.
Main Methods:
- Review of legal frameworks, including the Mental Capacity Act 2006.
- Analysis of principles for assessing capacity and making best-interest decisions.
- Inclusion of case studies and discussion of decision aids.
Main Results:
- Outlines principles for capacity assessment and best-interest decisions.
- Highlights the importance of shared decision-making involving patients, families, and carers.
- Demonstrates practical integration of legal frameworks and person-centered approaches through case studies.
Conclusions:
- Community nurses must actively involve individuals with dementia, families, and carers in care decisions.
- Legal instruments like lasting power of attorney and deprivation of liberty safeguards are essential.
- Decision aids can enhance autonomy and participation for people with dementia, promoting inclusive care.
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