Question

Elizabeth asks:
How can we assess if our mother with dementia is able to make a sound decision?

Tip

A diagnosis of dementia does not automatically mean someone cannot make decisions. What matters is whether they still have decision-making capacity.

Doctors determine this by evaluating whether a person can understand information, recognize consequences, reason through choices, and communicate a consistent decision.

Response

Elizabeth, this is one of the most common concerns families face when caring for a parent with dementia.

A person with dementia may still be able to make decisions in the early stages of the disease. What physicians evaluate is something called decision-making capacity.

Decision-making capacity means a person can:

• Understand the information related to a decision
• Recognize how the decision affects them
• Reason through the available options
• Communicate a clear and consistent choice

If your mother cannot explain the decision she is making, does not understand the possible consequences, or frequently changes her answer, it may indicate that her decision-making capacity is impaired.

When families notice these warning signs, it is important to speak with the physician and request a capacity evaluation. A doctor can assess whether your mother can safely make medical or financial decisions and document this in her medical record.

Addressing this early helps families activate Power of Attorney protections and prevent medical, legal, and financial crises.

Understanding these changes is also an important part of maintaining balance in caregiving — protecting your loved one while preventing overwhelming stress for the caregiver.

For a deeper explanation of the warning signs and how doctors determine decision-making capacity, read:

→ Does My Parent With Dementia Have Decision-Making Capacity? 5 Warning Signs Caregivers Should Not Ignore