Can Dementia Patients in Nursing Homes Refuse Care?

There are 50 million people around the world with dementia. By 2030, an estimated 82 million people will have this debilitating disease. Dementia's impact on a person's mental capacity makes it a challenge to treat and care for patients. With a growing number of people expected to develop dementia, the question of whether these patients can refuse care is an important one – particularly when it comes to nursing home neglect.

According to the Law Office of Matthew L. Sharp, patients who are competent to make decisions have the right to refuse or accept medical treatment. Dementia patients who are deemed incompetent, however, do not have the right to refuse or accept medical treatment. By law, all persons are presumed to be competent enough to make decisions unless it's proven otherwise.

It's not uncommon for dementia patients to refuse medical care, even when the benefits are blatantly obvious. Patients may refuse care because:

• They don't understand what they're being asked to do.
• They feel like they're being talked down to or told what to do.
• They are misinterpreting the environment or situation.
• They don't trust the caregiver.

When dementia patients refuse to eat, take their medication or otherwise carry on with their normal hygiene routine, caregivers may become frustrated and resort to abuse. Families need to be vigilant and be on the lookout for signs of abuse or neglect, as dementia patients are often unable or afraid to communicate their experience.

What happens to a dementia patient who is deemed incompetent? The court typically assigns the person a legal guardian who will make decisions on his or her behalf.

A family member can't just walk into the court, claim their loved one is incompetent and simply be assigned as his or her legal guardian. The court will require medical evidence of incompetence from a licensed physician. Competency hearings typically address specific tasks to ensure the person retains his or her basic rights.

Some dementia patients will be deemed incompetent to make some decisions and not others. In cases where the person is in a vegetative state, severely intellectually disabled or psychotic, the court would likely deem him or her incompetent.

Dementia can affect a patient's ability to make rational decisions, understand medical treatments and assess his or her surroundings.

Dementia can cause significant complications when it comes to medical decisions, particularly if the patient is unable to understand the medical treatment or weigh the benefits and risks.

Due to their impaired reasoning and communication skills, dementia patients are also at a much greater risk of becoming a victim of abuse and neglect. Dementia patients are often unable to comprehend the effects of medical treatments. The condition also causes social withdrawal, confusion, memory loss, mood changes and poor judgement. In many cases, dementia patients are unable to communicate neglect or abuse to other caregivers and loved ones.

Nursing home abuse and neglect cases can be challenging and complex to argue, but when families do their part to look for signs and gather evidence, the case has a much greater chance of success.