Providing Long Term Services & Supports to People with Impaired Decision-Making Capacity: Results of Data Analysis and Interviews Examining Needs and Characteristics of Persons with Impaired Decision-Making Capacity in Maine.

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Griffin, Eileen, JD; Olsen, Louise; Fralich, Julie T, MBA
Long Term Care Services; Maine; Impaired Decision Making Capacity; Disability and Aging; Cutler Institute; USM Aging Initiative; Policy; Health and Wellness; Health Policy; Public Affairs, Public Policy and Public Administration; Social Policy; Social Welfare
report description
Many of the ethical, legal and common sense principles underpinning our society are built on the assumption that each individual is an autonomous agent, with the responsibility and the authority to make his or her own decisions. For example, in normal circumstances, a health care provider cannot decide what treatment to provide a patient without first obtaining that patient’s informed consent. An adult daughter cannot decide it is time for her elderly father to sell his house, if her father is able to make that decision for himself. However, when an individual’s ability to make decisions is impaired because of dementia, intellectual disability, brain injury, mental illness or another condition, respect for individual autonomy has to be balanced against the need to protect an individual from harm or exploitation. Decision-making capacity has important implications for Maine’s long term services and supports (LTSS) system. Figure 1 shows the prevalence of impaired decision-making capacity among persons receiving LTSS in Maine in State Fiscal Year 2011; 17 percent of people receiving home care services, 56 percent of people receiving residential care services and 70 percent of nursing facility residents have either moderate or severely impaired decision-making capacity.