Skip to content
View in the app

A better way to browse. Learn more.
allnurses

A full-screen app on your home screen with push notifications, badges and more.

To install this app on iOS and iPadOS
  1. Tap the Share icon in Safari
  2. Scroll the menu and tap Add to Home Screen.
  3. Tap Add in the top-right corner.
To install this app on Android
  1. Tap the 3-dot menu (⋮) in the top-right corner of the browser.
  2. Tap Add to Home screen or Install app.
  3. Confirm by tapping Install.
Discussion

Dementia and decision-making

Hi, 

I had a patient today that broke his arm at his assisted living. He was prepped and scheduled for surgery. He knew how he broke his arm and was aware that he needed surgery.  I clarified with the night nurse if the patient would be able to sign consent forms and they confirmed he could. 

I get a call from the patient's son stating that the patient has dementia and he is the one that needs to make decisions on the patient's behalf because he is the medical power of attorney. 

I did not see in the chart that the patient had dementia and it wasn't clear to me the patient did have dementia.

Thankfully, everything turned out to be okay but I am curious how do you/your facility deal with patients with dementia and informed consent. I thought medical POA is when the patient is no longer able to make decisions? If the patient is oriented and knows what's happening, when does medical POA take control?

Maybe I am not understanding something or if someone can help guide me to find the information I am looking for. 

 

  • Quote

    • Featured Replies

    Your understanding is how I understand it.  I would ask your supervisor for guidance for the future, as I've been out of the facility setting loop so long, I'm not sure that I'm giving proper information 

  • Quote

    Your understanding is correct, the POA only becomes the decision maker once the patient is deemed to lack decision making capacity, which isn't assumed just because the patient has dementia.  It doesn't matter if they don't know what decade it is, their own name, etc, so long as they can understand what the physician believes is wrong, the proposed fix, and the benefits and risk of that fix then they have capacity.  This is assuming they haven't been legally declared incompetent by a court of law.

    It's certainly not unusual that family members who are POA are under they impression that they now get to be the decision maker or get to be involved in the patient's decisions, which isn't the case.  

  • Quote

    My understanding is that different states have different laws in regard to DPOA for Health Care.  

  • Quote

    • Join the conversation

    You can post now and register later. If you have an account, sign in now to post with your account.

    Guest
    Add a Comment
    Go to topic listing

    Currently Reading 0

    • No registered users viewing this page.

    Account

    Navigation

    Search

    Search

    Configure browser push notifications
    Chrome (Android)
    1. Tap the lock icon next to the address bar.
    2. Tap Permissions → Notifications.
    3. Adjust your preference.
    Chrome (Desktop)
    1. Click the padlock icon in the address bar.
    2. Select Site settings.
    3. Find Notifications and adjust your preference.