Facilitating decision-making by people with dementia: is spousal support gendered?

Abstract

The Mental Capacity Act 2005 clarifies the decision-making rights of people lacking capacity (such as people with dementia) and requires that carers and professionals support the individual in making decisions. This paper reports key findings from a qualitative study in England which examined the social process of everyday decision-making by couples living with dementia. The author identifies the various support strategies used by spouses when seeking to facilitate decision-making by their partners with dementia and highlights how these varied by gender. The paper examines the role of gendered support in influencing whether people with dementia are enabled to exercise their decision-making capacity and, in turn, if their decisional autonomy is facilitated. As the Mental Capacity Act lacks a gender perspective, the author recommends that its ongoing implementation should be strongly gendered to ensure that women with dementia receive the support necessary to exercise their capacity and agency.

Keywords:

• decision-making
• capacity
• agency
• gender
• rights

Acknowledgements

The research was ESRC-funded (RES-062-23-2038, awarded to G. Boyle and L. Warren). Many thanks to the couples who took part, the organisations that helped with recruitment and to the Research Assistants (K. Ludwin and E. Argyle).

Notes

1. Pseudonyms are used throughout.