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Understanding mental capacity
Understanding mental capacity

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1 Getting old

You will begin this week by thinking about some of the general issues related to getting old: popular assumptions about old age, risk and well-being, and life in residential care for people with dementia.

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Figure 1 Looking in the mirror: Old age presents a number of challenging life issues

There are deeply rooted cultural assumptions in all societies about the perils and the opportunities of growing old. Old age can be positively associated with experience, perspective and wisdom. It can equally be linked with decay, declining mental agility, decreasing cultural relevance and dwindling social expectations of the need for the views of older people to be taken into account. Unlike children who start with very little mental capacity and usually acquire more through their childhood, it tends to be assumed that older people will lose, not gain, mental capacity as they get older. The risks of inadvertently reinforcing negative stereotypes of older people lacking mental capacity are considerable. 

The universal reality is that the older a person is, the more likely they are to have physical health problems and the less likely they are to be able to undertake the physical activities that they did when young. However, declining physical health should not be conflated with declining mental capacity. The two issues must be examined separately, even though they interact. This is especially the case for the range of conditions known by the generic term ‘dementia’. Dementia is particularly relevant to mental capacity.