Last week, in my blog entitled “Red Flags of Incapacity”, I mentioned that certain barriers and physical changes associated with aging can be mistaken for signs of incapacity. As professionals, we need to be able to separate these from actual signs of incapacity, and work to reduce or eliminate their effect as much as possible.
These barriers include vision impairment, hearing impairment, and the beginning stages of dementia. As people age, vision impairment is common. It can affect a client’s ability to read, decrease mobility, cause general anxiety, and reduce confidence. It is important to ensure that clients know what they are signing, and are involved in the estate planning process. When providing draft documents to a client with vision impairment, draft the documents in a larger font, if possible. Ask your client if they have their glasses with them if they are squinting or seem to be leafing through the papers rather than reading. Another option is to read the documents aloud if your client appears to be having a difficult time.
Hearing impairment is very common in people as they age, is very stressful, and has been linked to depression. It can vary from general loss to inability to hear higher pitches or to distinguish speaking from background noise, to tinnitus. Hearing loss can be mistaken for anti-social or confused behavior. Some people try to mask hearing loss, and may nod or answer “yes” as they presume they should, which can either add to the appearance of confusion or not raise a red flag. If you suspect a client suffers from hearing loss, confirm that they can hear and understand you. Test by asking questions that require more than a yes or no. Ensure that hearing aids are worn and turned on. Be sensitive to background noise, speak clearly and at a reasonable volume and speed, and simplify questions by not asking more than one at a time.
Dementia is the general term for the progressive deterioration of a person’s mental capability and cognitive functioning. Different abilities can be affected and to varying degrees. Even where dementia is present, it is not the determining factor in the question of capacity. The beginning of dementia can cause depression, mood swings, violence or aggression, and sun-downing which can also add to the appearance of confusion. It is therefore always a good idea to arrange to meet with the client when they are likely to be “at their best”, often in the morning.
Sometimes behaviours that may look like symptoms of incapacity are actually symptoms of other changes that are common as people age. We must remember to be sensitive to these “barriers to communications” and do what we can to minimize the effect on our relationships with clients.
Until Next Time,