Assessment and support of decisional capacity in persons with dementia or mental health problems

KCE Reports 349C (2022)

For most of us, it goes without saying that it is up to us to take our own decisions concerning our own health. But, for some people, whose decision-making capacity is affected – in the case of mental illness or dementia, for instance –, the situation is unclear. A KCE report states that decision-making capacity is rarely black-or-white binary factor, but is instead a reality which fluctuates depending on the moment, the context and the type of decision to be taken. The individuals concerned need to be supported so that they can continue, wherever possible to take independently the decisions that affect their health and their care.It is sometimes difficult for carers to assess whether a patient is able to take a decision of a medical nature and to define what support they need. For this reason, it is necessary to train them in such matters. Initiatives that help patients express their preferences and wishes in advance can also play an important role in this regard.