It is a complex question to answer. A diagnosis of dementia itself does not mean that a person cannot make decisions regarding matters such as medical care, accomodation and financial management. A specific capacity assessment is needed to determine this.
In determining someone capacity, the degree of cognitive impairment, level of understanding, ability to register and retain information and insight are taken into account. The person needs a cognitive and neuropsychological assessment to determine this. Neuropsychologist, Occupational therapists can perform some aspects of this assessment. The medical assessment and opinion could be provided by either a Neurologist or a Geriatrician (Aged Care Specialist).
When making the assessments it is important to make sure that patient is not affected by any other co-existing conditions that can affect the results such as acute medical illness. Also different areas of capacity can reveal different results; for example a person may not be able to make complex financial decisions but may still be able to make decisions regarding other matters such as his health care, accomodation, peronal matters. Therefore it important to make specific recommendations. Collateral history form family and friends as well as patient's previous health/financial record are also important in making the decision.
If the specialist opinion following the assessment was that the person did not have the capacity to make decisions regarding financial management, and if that patient had an enduring power of attorney (POA) appointed when he still had the capacity, that POA can exercise his/her authority to make the decisions on behalf of the patient. If it is simple matters such as paying bills or rent, after having provided a medical letter, banks might accept a next of kin to authorise the payments.
For more complex financial matters, if the person did not have an enduring POA, an application will have to made to NCAT (NSW Civil and Administrative Tribunal) - Guardianship Division, for the legal apointment of a substitute decision maker. NCAT can appoint a financial manager to manage the financial affairs of a person who is incapable of making their own decisions about their finances. NCAT only hears applications where there are no appropriate arrangements already in place or where an appropriate alternative to an application cannot be found. NCAT may decide to appoint a private financial manager (family member or friend) or the NSW Trustee and Guardian.
Hope the above information was helpful!
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