The importance of an early diagnosis of dementia is not limited to the clinical management through treatment with anti-dementia medications. A crucial component of dementia care is to enable a person with dementia to make decisions in respect of their own care and treatment. An early diagnosis provides the opportunity for timely discussions about future care needs and the chance for the individual to consider their advance care plan (ACP) at a time when the person retains capacity or, at least, can be an active participant. A person may wish to consult a solicitor or create their own advance decision, lasting power of attorney or will, while they still have capacity to do so.

In this chapter, we will consider the pathway for diagnosing a person with dementia and the legal corollaries of such a diagnosis rather than the organisation or implementation of advance care plans. The considerations are universal when applied to settings where a person is first diagnosed with a dementing illness. The importance of these cannot be overstated in the context of the progressive and deteriorating trajectory.

The effects of dementia can make older people particularly susceptible to abuse and exploitation. Not only are they likely to be less able to articulate their feelings and experiences, but they may also be unable to remember or understand what has happened to them. People with dementia may also be less likely to seek help, advocate for themselves or have the mental or physical capacity to remove themselves from potentially abusive situations. The relatively high psychological and physical demands placed on family members who care for relatives with dementia may be a contributing factor. We will therefore discuss the law in relation to safeguarding, provided by the Care Act 2014. We will then consider how the three relevant acts, the Care Act, the Mental Capacity Act and the Mental Health Act, may be deployed in relation to safeguarding situations. Finally, we will discuss safeguards relating to lasting powers of attorney, and what to do if one has concerns about attorneys and deputies.

When undertaking any intervention for an individual, you must be mindful of the legal authority or justification for the act. By intervention, we mean the full gamut of medical treatments or any act that relates to the care or welfare of that person. In this chapter, we will first consider the general legal principles that apply in almost any setting, but we have then divided the subsequent sections based on the location where care is predominantly provided (i.e. a domestic/home situation, care home or hospital). Although this is somewhat arbitrary, it broadly correlates with the progressive deterioration of the clinical state and in the transitions from living at home, to hospital or care home and through to the end of life. It therefore allows us to consider some situation-specific questions and how the law applies in negotiating the moves between locations or care settings.

Persons with special needs are in an extremely vulnerable position where they are potentially subject to financial abuse by rogues. Unfortunately, policy makers and scholars have not given this problem sufficient consideration. Drawing from the Singapore experience, this chapter explores the financial planning mechanisms available to persons with special needs which currently exist through legislation and various government and non-profit initiatives. It then considers several case studies of financial abuse of persons with special needs to expose the potential systemic weaknesses in the current regime. The aim of the chapter is to provoke a conversation on how societies can do better by enacting laws and implementing schemes to prevent financial abuse of persons with special needs.

This chapter examines adult guardianship and powers of attorney in England and Wales today. Section I considers the origin of modern adult guardianship law in Roman law and traces its development in English common law through to the current legal and institutional infrastructure of mental capacity jurisdiction. It then introduces the procedures of appointing a deputy, and evaluates the safeguards provided by the Office of the Public Guardian. Section II focuses on the policy considerations underpinning the legislation on enduring and lasting powers of attorney, the development of policy and legislation over the past 35 years, and potential developments in the foreseeable future. The author also compares deputyship with attorneyship, and explains the advantages of the former over lasting powers of attorney.