“If someone who is alert and aware makes a conscious choice to live in unclean, potentially dangerous conditions, as long as it doesn’t affect others, they have the right to refuse help.” That is correct. However, the devil is in the details. We, as a society, including doctors, lawyers, judges, and other professionals in elder care, often miss early dementia (the loss of executive function) where someone superficially sounds fine, or has an MMSE (Mini-Mental State Examination) of 25 or knows time, place and self. They are too quickly judged competent and left to their own devices. I would STRONGLY advise that if elders sound fine but are acting in very concerning ways such as letting strangers into the house, giving money away, and other unusual behaviors out of context of their usual behavior for the last many years, get Neuropsychological testing. That is the only way to see who really has “the right to folly” and who has early dementia with loss of judgment before the loss of orientation or social skills.
Elizabeth (Dr Liz) has over twenty years of experience in providing medical care to the elders. She is board-certified in Internal Medicine, Geriatric Medicine and Palliative Care Medicine. Dr Landsverk founded ElderConsult Geriatric Medicine, a house calls practice, to address the challenging medical and behavioral issues often facing older patients and their families.