As dementia is a progressive disease, there will come a point when the patient no longer has the capacity to make informed decisions. This occurs when they are unable to do the following:

• Understand information
• Retain information long enough to make a decision
• Weigh up information
• Communicate their decision by any means (e.g. blinking).

The Mental Capacity Act (MCA) 2005 provides a statutory framework to protect people who no longer have the ability to make decisions about their own care. Pharmacy professionals should be aware of the implications of this Act in relation to decisions to take medicines and requests from other HCPs and care home staff for information about the covert administration of medicines. Advance decisions are legally binding statements that enable a person to state how they wish to be treated should they become unable to communicate. These often cover resuscitation or end-of-life treatments.