To encourage acceptance, the individual who agrees to limits should be assured that others will assist in providing transportation. When an individual loses insight, however, family members may even have to disable the motor vehicle. Autonomy, Capacity and Competence People with dementia should be allowed to exercise their remaining capacities for specific tasks and choices. Denying these choices challenges their independence and dignity. Decision-making capacity includes capacities to understand and communicate, to reason and deliberate on future consequences, and to possess some stability in values and goals.
Family members can avoid considerable conflict by identifying alternatives to risky activities.
Ideally, loss of a privilege is balanced by offering ways to fill the gaps, diminish the sense of loss and retain a sense of self-control. In order to extend one's autonomy prospectively when loss of capacity is anticipated, estate wills, living wills and durable powers of attorney for health care are necessary. Laws on living wills vary from state to state, so patients and families should be advised to consult a legal expert or contact the state bar association for legal guidance. Legal judgments of competency and incompetency should reflect the mental condition of the person with dementia, not the needs or intolerance of others. Poor hygiene, lack of inhibition, inclination to mishaps and inability to maintain residences in good appearance are not of themselves grounds for a finding of legal incompetence.