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As a loved one grows older, or lives with a condition such as dementia, families sometimes find themselves worrying about decision-making. Who decides what is best? And, importantly, is my loved one's right to make their own choices still respected and protected?
It is a sensitive and genuinely important area, guided both by law and by a deep respect for the person at the heart of it. Here is how our carers approach mental capacity, and how we protect your loved one's right to choose for themselves, for as long as they possibly can.
Mental capacity means a person's ability to make a particular decision at a particular time. A few things about it are worth understanding, because they are reassuring and often misunderstood:
Everything our carers do around decision-making is guided by a set of principles rooted in law and in genuine respect for the individual:
Together, these principles protect your loved one's freedom, independence and dignity.
It is worth being clear about the carer's role here. Carers do not carry out formal capacity assessments, and they never make significant legal decisions on their own. Those are handled properly by our care managers, and where needed, by the right professionals.
What a carer does is just as valuable in its own way. They support your loved one to make their own decisions wherever possible, they gently notice and note any changes (in understanding, communication, confusion or distress), and they raise any concerns promptly with our care management team. So there is always a knowledgeable team behind the scenes, and no important judgement rests on a carer alone.
If your loved one is properly assessed as unable to make a specific decision, a decision can be made on their behalf, but only under careful conditions. It must be genuinely in their best interests, it must be the least restrictive option, and it must be made after consulting the people who matter, including family, any appointed representatives, and relevant professionals. Even then, your loved one is supported to be as involved as they possibly can be. It is never done lightly, and never in isolation.
Sometimes, keeping someone safe may call for certain restrictions. This is something we take extremely seriously, because a person's liberty matters enormously. Any restriction must be truly necessary to prevent harm, proportionate to that risk, and the least restrictive approach possible.
Restraint is never used for convenience or as a punishment, ever. And medication is never used simply to manage behaviour unless it has been properly prescribed, is clinically justified, and is documented and regularly reviewed. Where any restriction is significant enough to affect a person's liberty, it is handled carefully and lawfully, with the proper safeguards and authorisations in place. We are watchful about all of this precisely because it protects your loved one.
If your loved one has planned ahead and appointed someone through a Lasting Power of Attorney, or if a court has appointed a deputy, that person is involved in decisions made on their behalf. And if someone lacks capacity for a decision and has no family or friends able to represent them, an independent advocate (known as an Independent Mental Capacity Advocate) can be brought in to speak up for them. Our care managers coordinate all of this, so the right people are always involved.
One of the strongest protections of all is that our carers are trained and encouraged to raise concerns. If a carer ever feels your loved one is being restricted too much, is struggling to make a decision safely, or is being treated in a way that feels excessive, they report it straight away, and they are always supported for doing so. That watchfulness helps keep your loved one's rights firmly protected.
Mental capacity, in the end, comes down to a simple and profound idea: everyone has the right to make their own choices for as long as they are able, and to be treated with dignity and respect even when they need help deciding. That belief runs through everything our carers do.
If your loved one is living with dementia or another condition that affects decision-making, you may find our guide to dementia care helpful too. And if you would like to talk through how we would care for someone you love, we are always here.
Book a free care advice call, or give us a ring on 020 3970 9900. We are happy to help.
This guide offers general information about how we approach mental capacity in care, and is not legal advice. For specific matters, such as setting up a Lasting Power of Attorney, please seek appropriate legal guidance or see gov.uk. This guide reflects our approach as of 2026.
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