Decision-making capacity and older adults – part 2

Decision-making and cognitive decline concerns – what does it mean in Michigan?

As our population continues to age in the United States and Tribal Nations, we may notice an increase in the amount of patients who demonstrate a decline in their ability to make well informed decisions. As health care providers, family and friends it is important that we are aware of the person’s declining cognition, and just as important to ensure their wishes have been well documented for future reference.

Listed below are some areas that are important to discuss with the elder adults in your life:

  • Independent living – The ability to continue living in their own home with little to no assistance.
  • Financial management - Make sure that your loved one’s money will be managed according to their wishes and that their financial resources will cover their medical care and needs as much as possible. For more read Legal & Financial Issues in Caregiving for Older Adults.
  • Treatment consent – Legal right to accept or refuse treatment or care.
  • Testamentary capacity- The ability of a person to make a valid will.

The truth is, at any point in our lives we all could be at a point where we cannot be capable of making a safe and sound decision. This is why completing documentation such as a Durable Power of Attorney (DPOA) is helpful to have completed. When situations arise where a person may not have appointed a DPOA this then requires further evaluation and discussion with the persons spouse and, or family members. There may be concern that once a DPOA is appointed that this decision cannot be changed. This is not true. A person may change their DPOA at any time they wish and for any reason. Those reasons may include:

  • A change in relationship
  • A change in mental/physical status
  • An occurrence of elder abuse – physical, mental, sexual or financial
  • A change in geographical location

These are very important yet, difficult matters to talk about with our family, friends, loved ones and community members. We may struggle through these different situations, especially since we value our freedom to make decisions, and at times find ourselves having to make difficult life changing decisions with and for our elders and older adults. There are many resources in Michigan that are able to assist families in talking through these different situations such as:

To learn more about health and nutrition and disease prevention programs offered through Michigan State University Extension please contact myself, Emily Proctor at (231)-439-8927 or

For more on this topic read part one, Decision-making capacity and older adults.

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