When an aging loved one starts making what you consider poor decisions, it’s worrisome. Are they no longer thinking straight? Is this normal aging or something more serious? There are two terms to know when concerns arise about cognition: capacity and competence.
Capacity is a medical term. Having capacity means you can understand information, consider choices, and communicate a decision. Capacity is not all or nothing. For example, your relative may be able to choose what to wear or agree to a medical test. But they may struggle with paying bills or understanding medication changes.
Capacity is changeable. Your loved one may think clearly in the morning but be confused later in the day. Illness, depression, or medication side effects may affect their ability to make decisions. A medical evaluation can assess capacity for certain types of decisions.
Competence is a legal term. Attorneys assess a person’s capacity to address legal issues. Or complete legal documents. Only a court can decide that your relative is incompetent. It means they have shown incapacity to manage life functions overall. If your family member has not named someone to act on their behalf through durable power of attorney, the court may appoint a guardian or conservator.
When to seek an evaluation. Forgetfulness alone does not mean someone can no longer make decisions. But changes deserve attention. Contact your loved one’s primary care doctor and explain your concerns. Ask for a memory screening or capacity evaluation to establish a baseline.
If your relative can still make decisions, now is the time for them to complete legal documents. Specifically, a durable power of attorney and an advance directive. This allows them to name decision makers who can act in their place if needed. If their cognition worsens, those choices may become much harder to make and may require court action.