Project Contact: Krista James
Telephone Number: 604-822-0564
Email Us About this Project
The goal of this project is to:
- Work with people with different kinds of disabilities to identify strategies that can support people living with dementia to be meaningfully involved in decision-making; and
- Create resources for teaching healthcare stakeholders how to support people living with dementia to participate as much as possible in decisions that impact their lives.
The need for this project was identified through consultation with the community. Stakeholders and committee members who participated in the Health Care Consent Project told us that while law reform can enhance rights, education and capacity-building are critical to ensuring that rights are respected. Recommendation 22 of our report Conversations about Care states:
In order to better support the practice of all health care professionals and staff, best practice guidelines should be developed which addresses how to:
- Engage people who are living with dementia in health care decision-making; and
- Maximize the capacity of people living with dementia to participate in their health care decisions.
Meet the council
The Dementia Advisory Council
The Council will meet regularly throughout the project to participate in key project decision-making and events. You can find out more about all the council members by clicking on the image below.
Systems Change Grant
With the support of a Vancouver Foundation’s Develop Grant, our activities to date have included:
- Conducting research on promising and best practices resources which identify strategies for including people living with disabilities in decision-making. A literature review was published in early 2020 (see bottom of the page).
- Hosting a small disability stakeholder forum in Vancouver on the International Day of Persons with Disabilities (December 3, 2019). The forum brought together people from different disability communities so they could share strategies that have worked in their own lives.
Thanks to a new Vancouver Foundation Test Grant, we will leverage knowledge across disability communities, and engage health care stakeholders, family caregivers and people living with dementia in developing educational resources to support this system change.
People living with dementia often find that their decision-making rights are not respected. Some people assume that if you have dementia you cannot understand information or make choices. This exclusion happens within health care institutions and also within the larger community. Our research suggests that the following factors contribute to this dynamic:
- Ageist and ableist attitudes toward older people who have disabilities;
- Inadequate understanding of dementia and its impact on decisional capacity;
- Staffing issues that result in lack of time and resources to support a person’s capacity;
- Lack of knowledge of legal rights and duties in relation to health care consent; and
- Health care institution emphasis on patient outcome over decision-making processes.
International and domestic laws are clear that capacity to make a health care decision depends on the specific decision in question, and that every adult should, at the outset, be presumed capable of making their own health care decisions. As such, people living with dementia and other disabilities that impact their ability to understand information are entitled to make some or all of their health care decisions at different times in their lives—depending on their ability to understand information and communicate their preferences at the relevant time. Research also indicates that decisional capacity can vary across the dementia journey—even within a single day—and that trauma, stress and other factors can further undermine capacity. In contrast, other factors, such as support with decision-making and communication, can enhance decisional capacity.
The Disability Stakeholder Forum
Thank you to everyone who attended our disability stakeholder forum on December 3, 2019. The infographic below shares themes that came up during our half-day of discussions
To read our most recent project update, click here. (January 2020)
This website and its publications are not legal advice. Need legal assistance? Visit our Resources page.
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