A crucial aspect of dementia care is understanding and managing ▶ cognitive fluctuations, which are changes in a person's cognitive abilities and levels of awareness.
Dementia is a progressive neurological condition that encompasses various forms such as Alzheimer's, vascular dementia, Lewy Body dementia, and frontotemporal dementia.
The Australian Institute of Health and Welfare estimates that there were ▶ 219,000 Australians with dementia in 2020. This number is on the rise.
Cognitive fluctuations can be influenced by factors like:
1️⃣ environment,
2️⃣ fatigue,
3️⃣ medications, and
4️⃣ time of day.
For example, ▶ sundowning is a common phenomenon where individuals experience increased agitation or confusion during late afternoon or evening hours.
The neurobiology underlying cognitive fluctuations is not yet fully understood, but it is known that dementia results from damage to brain cells and their connections. In Alzheimer's disease, this deterioration begins in the memory centers of the brain and gradually spreads to regions governing attention and awareness.
Disruptions in the brain's "default mode network" can also lead to changes in cognition and self-awareness.
Behavioural interventions, such as music therapy, can temporarily improve mood and memory for those living with dementia.
When interacting with a loved one experiencing cognitive fluctuations, it's important to:
➡ communicate effectively using short sentences,
➡ maintain eye contact,
➡ minimise distractions, and
➡ listen calmly to their concerns.
Although some drugs show promise in slowing memory decline, further research is needed to better understand and treat dementia.
If you are facing guardianship issues related to dementia, I am a specialist guardianship lawyer and can help.
7 Simple Ways to Reduce Fall Risk for People with Dementia
7 ways to prevent falls for people with dementia
A hospitalisation from a fall is a common theme in my guardianship cases where the Subject of the SAT application has dementia.
Did you know that falls are one of the leading causes of hospitalisations for people with dementia?
A study showed that 26% of individuals with Alzheimer's were hospitalised due to falls, and people with dementia experience 8 times as many falls as those without dementia.
To help prevent falls in your loved one with dementia, here are 7 simple ways you can reduce fall risk:
1️⃣ Review their medications with a healthcare provider, as some medications can increase the risk of falls
2️⃣ Consider their medical conditions and diagnoses, such as Parkinson's disease or changes in blood pressure
3️⃣ Talk to their doctor about the best time of day to take medications to decrease falls risk
4️⃣ Be extra alert and vigilant during concerning times for falls
5️⃣ Do tests to assess their fall risk, such as closing their eyes while standing
6️⃣ Implement safety measures in the bathroom, such as using a shower chair or bench
7️⃣ Reduce fall risk by being mindful of when blood pressure changes can occur
When I speak to clients, concerns about falls risks come up time and again, and are a top-of-mind risk for Public Advocate Investigators when doing reports in advance of a hearing. Something to be mindful about when caring for people with dementia.
The Risks of Using a Generalist Lawyer in Guardianship Matters
Guardianship and administration cases can be complex and emotionally challenging, requiring specialized knowledge and understanding of the laws and procedures involved.
In these situations, having a lawyer who is familiar with the process can provide important guidance and support.
Here are some of the risks of using a generalist lawyer in guardianship and administration matters:
1️⃣ Lack of familiarity with the laws and procedures involved, leading to mistakes and costly delays.
2️⃣ Difficulty in advocating for the client's rights and interests, as the lawyer may not be fully aware of the relevant laws and regulations.
3️⃣ Lack of understanding of the emotional and personal issues involved in these cases, which can make it difficult to provide the necessary support and guidance.
As a lawyer specializing in guardianship and administration in Western Australia, I have a deep understanding of the legal and emotional challenges that my clients face, especially in the context of an aging population. In Western Australia, the population is rapidly aging. According to the Australian Bureau of Statistics, 21.8% of the population was aged 60 years and over in 2021, and this number is expected to increase to 24.7% by 2031.
My goal is to provide clear and concise information about the process and help clients make the best decisions, at such a difficult time in their lives.
The Importance of Properly Evaluating Mental Capacity in Legal Matters
There is no single legal definition of mental capacity in Western Australia. As a lawyer specializing in guardianship cases, this question is frequently top-of-mind when dealing with some of my clients.
It is important to understand the nuances of determining mental capacity in legal matters. The definition varies depending on the type of decision or transaction involved.
There are various legal tests for mental capacity, such as the test for testamentary capacity.
Despite the many different legal tests, the fundamental issue is whether the client is able to understand the general nature of what they are doing. If there is ongoing difficulty in this level of understanding it may indicate a lack of mental capacity which requires further exploration by the lawyer.
Any work done for a client who it later turns out lacked mental capacity could be invalid and expose the lawyer to potential legal and ethical issues.
For example, a client may appear to have the mental capacity to create a will, but in reality, they may be suffering from dementia and unable to understand the consequences of their actions. This could lead to the will being challenged and the lawyer facing potential legal repercussions.
Another example is, a client may not have the mental capacity to make a contract, but have mental capacity to make a will. A lawyer should be aware of this and should not proceed with the contract if they suspect the client lacks mental capacity. If a lawyer fails to do so, it could lead to the contract being challenged and the lawyer facing potential legal repercussions.
See a publication produced by The Law Society of New South Wales entitled “When a client’s mental capacity is in doubt – A practical guide for solicitors”, dated 2016" for more information.
Navigating Guardianship Applications: Some “signs” for Families Affected by Dementia
GUARDIANSHIP ... it is important to be aware of the early signs of dementia and the difference between dementia and Alzheimer's disease.
Dementia is the term used to describe losing one's memory and speech, with Alzheimer's disease being the most common cause.
In the early stages, it may appear as exaggerated forgetfulness, but as the disease progresses, memory loss, changes in thinking and speech, and changes in behavior may occur.
Other diseases that can cause dementia include vascular dementia, caused by small strokes, and Lewy body disease, which also presents symptoms similar to Parkinson's disease.
Although dementia is not hereditary, an early diagnosis is important as there are treatments that can be offered and it is important to prepare for the future.
Keep an eye out for extraordinary forgetfulness and out of character behaviour, such as putting food in the wrong place or tripping over words in conversation.
If you notice these signs, encourage your family members to seek medical attention for a proper diagnosis.
If you or someone you know needs help applying for or dealing with a guardianship application at the State Administrative Tribunal of Western Australia, please don't hesitate to contact me for assistance. I'm here to help, having acted in more than 100 such applications during the last 5 years.
Successful Review of Guardianship and Administration Decision in Western Australia
We recently acted for the applicants in a review of a decision made under the Guardianship and Administration Act 1990 (WA). You can read the full decision here.
The applicants, MD and DM, applied for a review of a decision made by a single member of the Tribunal, Member Conley, on 6 September 2022.
In the original decision, Member Conley declared that the represented person (NA) was unable to make reasonable judgments in respect of matters relating to her estate, person, and health and safety, and therefore needed an administrator of her estate and a guardian. The Tribunal then made orders revoking the enduring powers of attorney and guardianship in place and appointed the Public Trustee as plenary administrator and the Public Advocate as limited guardian.
On our clients behalf, we then applied for a review by the Full Tribunal.
After reviewing the case, the Full Tribunal decided to revoke the original orders and reinstate the enduring power of guardianship and power of attorney in favour of MD and DM.
In relation to guardianship, the Full Tribunal found that NA was unable to make decisions regarding her own health and safety and needed oversight, care, and control. However, the Full Tribunal also found that a less restrictive means was available in the form of an enduring power of guardianship (EPG) previously made by the individual. As a result, the Full Tribunal revoked the orders appointing a limited guardian and reinstated the EPG, naming two of the individual's daughters as joint guardians.
In relation to administration, the Full Tribunal found that NA’s vascular dementia rendered her unable to make reasonable judgments in relation to matters concerning her estate, but that the appointment of an administrator was not necessary as the less restrictive option of the enduring power of attorney in favour of MD and DM was available.
We are proud to have been able to assist MD and DM. A job well-done by Isaac Priddis, who appeared for our clients at the hearing.
If you would like to hire a lawyer to act on your behalf in a guardianship matter, please don't hesitate to contact me. I would be happy to discuss your options and how I can assist you.
I acted in 30 separate such matters in 2022 alone and offer a specialist service.
Guardianship Specialty: Protecting Loved Ones with Dementia
One of my 3 specialities is GUARDIANSHIP.
I often encounter clients who are seeking guardianship for loved ones suffering from dementia.
Dementia refers to a decline in cognitive function, which includes memory, language, problem-solving, and decision-making abilities. It can be caused by various conditions, such as Alzheimer's disease, stroke, or brain injury.
In the context of guardianship applications, the State Administrative Tribunal of Western Australia considers whether an individual has dementia when determining whether they are capable of making decisions about their own care and welfare.
If the Tribunal determines that an individual lacks capacity due to dementia, a guardian may be appointed to make decisions on their behalf.
Dementia is a progressive condition, meaning it will get worse over time. As such, it's important to plan for the future and ensure that appropriate guardianship arrangements are in place to ensure the best possible care for loved ones suffering from dementia.
If you or someone you know is seeking guardianship for a loved one suffering from dementia, don't hesitate to reach out. I've dealt with 100s of these matters over the years and offer a comprehensive service.
Protecting Individuals with Dementia from Financial Abuse
Dementia can have a significant impact on financial decision making, including:
- Struggling to understand financial concepts
- Difficulty remembering important financial information
- Inability to manage money effectively
These challenges can lead to financial abuse and exploitation, as well as financial instability for the individual and their family.
To protect individuals with dementia, the Guardianship and Administration Act 1990 (WA) offers administration orders. These orders appoint a guardian or administrator to manage the financial affairs of an individual with dementia and provide necessary support and oversight.
It is important to note that administration orders should be considered as a last resort, as they do limit an individual's autonomy and decision-making capacity. However, in cases where an individual with dementia is at risk of financial abuse or is unable to manage their own finances, an administration order can provide much-needed protection and support.
As a specialist in guardianship and administration in the State Administrative Tribunal of Western Australia, I have acted in 30 different cases related to this area of law in 2022 (and counting).
With an ageing population, families may become more aware of the financial exploitation risks associated with dementia during times like the Christmas season.
If you or a loved one are dealing with dementia and financial decision making, I am here to help. I offer a comprehensive service and deeply care about the needs of my clients when they apply for guardianship and administration orders over family members. Do not hesitate to reach out for assistance.
New Technology for Diagnosing Alzheimer's Disease
As a lawyer who works on guardianship applications in the State Administrative Tribunal of WA every day, I spend much of my time reading medical reports.
These are relied on by the Tribunal to whether the presumption of capacity is rebutted in an individual case.
Will be intriguing to see this new technology for diagnosing Alzheimer’s in action.
Hopefully it brings more certainty, when it comes to determining if (and crucially, when) there is a need for a guardianship order to be made after a family member begins displaying symptoms.
Click here to read the full article.