Should dementia patients be held legally accountable for their decisions when the law explicitly allows them to exercise their rights?

Exactly -- nonsense about rights. What it really means is that the rights of the DISEASE take precedence over the right of the person to have the best life they can have (with the disease).

Ultimately, someone, at some point, must assume the responsibility for STATING that an individual’s cognitive level as of (date) is such that he/she is not capable of managing his or her affairs.

”Legal” may be slightly different from “psychological, intellectual, cognitive” failure, so in our situation, the gold standard was a letter from LO’s psychiatrist with input from her medical doctor.

My LO has the right to be protected and cared for by someone who loves her, can make objective, well informed, compassionate decisions on her behalf, and always ALWAYS has her prior pre-dementia choices, intentions, and desires in mind.

As a sensitive, intelligent, responsible woman before her illness, she would want to have been prohibited (denied “rights”) from driving, using dangerous equipment, squandering her hard earned resources, and behaving in a way that would cause her to do things that would be dangerous or hurtful to others.

Do these thoughts seem to sum up rights? Any other thoughts, or anything I’ve missed?

Like what?

It does not follow that because you are unable to exercise legal autonomy you have no rights, and no choices. Children have rights. Unconscious patients have rights. So do people with dementia.

I agree that it can be very frustrating. You feel, for example, that your mother's safety demands 24/7 care in a facility. She has the right to refuse, and does. Then either she comes to harm, and you feel responsible even though the harm is the result of her decision; or you feel obliged to remain in her home providing 24/7 care but unwillingly and against your better judgement, and you naturally resent it.

But you have a choice there, too. You can walk. Your mother has the right to make her decisions, but not to make yours.

Moreover, decision-making ability does not have an on-off switch. You may legally have taken over the major decisions such as where she is to live, or whether she should opt for surgery. That doesn't give you the right to decide she can't see the brother you intensely dislike, or to change her diet to foods that are better for her.

What has your LO done that has driven you to the keyboard to vent today, can I ask, do you mind?

It's true that it makes no sense. Social workers should stay in their lane - help people apply for government programs and longterm care beds, etc - instead of acting like human rights attorneys. They can be confrontational and obtuse. Many of them seem to care not one iota about the realities facing caregivers and make suggestions regardless of cost or inconvenience to the caregivers.

Caregivers do not have to succumb to anything. Document the actions, document the forgetting, and document your attempts to keep them safe. All one can do is try. Do not sign anything except as POA.

This is a great topic for discussion. It's why I believe strongly that no one should take on the responsibility of caregiving for someone - dementia or not - without having financial and medical POA. Even spouses need to have that important paperwork.

This is an excellent post and gave me a long pause for thought. We recently had a question about a person with “serious cognitive impairments” who was irate because his daughter removed his guns from the house. 95% of posters advised to remove the guns from the house post haste. I was taken to task by a poster and advised that should the gun owner decide to press charges, the person who removed the guns could be charged with theft. Valid point, But, others chimed in and asked if the impaired man felt threatened and pointed a gun, even an unloaded one, at someone, even the police, it could have a very tragic result. Also a valid point.

Would a social worker support the man’s rights to have his guns in the house with him despite the fact that he is impaired? What if, God forbid, something DID happen? Who would be held responsible? Would the man’s family be vilified for not removing the guns by the same people who previously had protested that the man had “rights”?

Very interesting question. I am anxious to see how others will respond.

Accountability for bad behaviors, and for not being able to care for one-self equates to landing inside a facility. If, someone cannot care for themselves, yet they have their cognitive neurological capacities in tact, then after further evaluation, if they're continue to deteriorate, then they will be carted-off to a medical facility eventually.

Ahmijoy: "Would the man’s family be vilified for not removing the guns by the same people who previously had protested that the man had 'rights'? "

That is a GREAT question! Perhaps the bar for mental competence is too low.

There are some exceptions. For example, if they appear reasonably to have capacity, the other party could rely on that.

Otherwise, no elderly person would ever be allowed to enter into any contract.