Our memories are important for our identities, or who we are.
So, when memories start fading slowly, or dementia starts setting in, it touches everyone in the family.
It has been a couple of months since my mother was diagnosed with dementia,, and things have become so unpredictable since then.
On some days, she is absolutely fine, cooperating with us by taking her food and medicines properly.
On other days, she will not just listen to us and refuse to eat or even stop trusting us with her care.
A 2025 Alzheimer’s Society survey found that 76% of respondents affected by dementia had lost their independence in everyday activities.
There are even differences about small choices such as who drives or who manages the medications.
Furthermore, often, the person with dementia thinks that their opinions do not get enough importance.
In a way, it is a matter of concern, as a person’s right to make an imperfect choice doesn’t automatically disappear because dementia has entered the picture.
Or does the right to make choices really disappear?
The entire discussion today revolves around this trade-off between dementia care and autonomy.
Key Data Points At A Glance
| Key Data Point | What It Shows |
| 76% | Respondents affected by dementia who reported losing independence in everyday activities (Alzheimer’s Society, 2025). |
| 82 studies | Reviewed in The Gerontologist (2025), which found people with dementia often keep everyday decision-making ability when given support. |
| 70% and 97% | Dementia caregivers who find coordinating care stressful, and those who say care navigation services would help (Alzheimer’s Association, 2024). |
| 37.2% vs. 28.6% | Emergency visits by older adults with Alzheimer’s that led to hospitalization, compared with those without it (CDC, 2024). |
Does Dementia Take Away The Right To Decide?
No, dementia does not take away the right to decide legally.
Someone with dementia may struggle with complex financial decisions.
However, they may be perfectly capable of making choices about their everyday activities.
A 2025 research review published in The Gerontologist examined 82 studies on personal autonomy in dementia.
The study found that people with dementia have the ability to make everyday decisions.
Also, they can participate in various social activities depending on their communication skills and how they are involved.
Now, while this looks like a plus point or a thumbs up for autonomy, it does not eliminate the need for proper care.
To begin with, you must consider each decision separately.
Consider the risks involved, and offer support before assuming someone can no longer decide for themselves.
The Frequent Collision Between Protection And Control In Dementia Care
Now, all the restrictions I impose on my mother come from the fact that I worry about her being harmed.
However, I can see her frustrations sometimes with me controlling things or deciding for her.
Also, when someone is suffering from dementia, the reflection is visible in their moods and confidence.
With me now being a regular caregiver to my mother, I can see how the tussle between autonomy and care becomes prominent in everyday situations.
Managing Money And Bills
Is the family member with dementia forgetting the payments or are they vulnerable to suspicious withdrawals?
If yes, they need proper financial oversight.
Handling Medications
I really think this part needs guidance as missing or having wrong does or medicines can cause severe medical problems.
Also, maintaining the right schedule for medicines can be a difficult task for someone with dementia.
Moving To Assisted Living Or Memory Care
A person with dementia may need residential care if staying at home has become unsafe.
However, leaving the familiar surroundings can be upsetting for them.
The Wandering Risk
This is the last thing you want to happen.
A person with dementia may leave home to visit a friend or go to a shop.
Then, they completely forget to return home
Elizabeth Edgerly, a senior director at the Alzheimer’s Association, explained in a 2026 NPR report, “At the most basic level, wandering means that someone walks away and has trouble finding their way back.”
You can prevent outings for these individuals. However, this can again lead to loneliness and lack of interactions or physical activities.
Sharing The Decision Load
Let me be honest!
Caregiving decisions at home are difficult when a particular family member handles everything.
I know how the situation is, and now my mother stretches her arms like a toddler so that I help her get up from the bed.
In fact, a 2024 Alzheimer’s Association report found that 70% of dementia caregivers considered coordinating care stressful.
Another 97% said professional care navigation services would be helpful.
To counter the national nursing shortage, many accredited universities now offer online DNP programs.
The hybrid format lets working nurses add this credential without leaving their jobs.
Making Room For Independence In Everyday Care
Autonomy shows up in ordinary routines long before any legal question arises, so everyday habits carry plenty of weight. The way caregivers ask, adapt, and wait can protect a person’s sense of control without adding risk. These four habits are a good place to start.
- Try to offer choices instead of open-ended questions: Picking between two outfits or meals feels easier than facing endless options.
A simple “Would you like the blue sweater or the gray one?” keeps the decision with the person.
- Adapt activities instead of removing them: Someone who can no longer cook a full meal may still stir, season, or set the table.
These simple, familiar tasks can help them feel useful and keep a favorite routine alive.
- Let small things go: Not every forgotten detail or unusual preference needs a correction.
Mismatched socks can pass without comment when nobody’s safety is involved.
- Give people time to respond: Memory and processing difficulties don’t mean your loved one has nothing to add.
Waiting a few extra seconds can bring out an answer you’d have missed by jumping in.
Knowing When Safety Must Come First
Some risks are reasonable to accept, while others call for intervention.
Families need to consider the seriousness of potential harm without unnecessarily limiting the person’s freedom.
A 2024 CDC report found that 37.2% of emergency department visits involving older Americans with Alzheimer’s resulted in hospitalization, compared with 28.6% among those without the condition.
A few considerations can help families make these decisions:
- Recognize serious risks: Repeated medication errors, unsafe driving, or getting lost outdoors may require immediate action to prevent harm.
- Keep restrictions specific: Someone who can no longer drive safely may still visit friends through arranged transportation. One limitation shouldn’t automatically affect other freedoms.
- Check for underlying causes: Illness, fatigue, or medication side effects can worsen confusion. A healthcare professional can help identify treatable problems before lasting restrictions are introduced.
That said, even when intervention becomes necessary, the person’s preferences should continue to influence how care is provided.
Disclaimer: This content is for informational and educational purposes only and does not constitute medical, legal, or professional advice.
Always consult a qualified healthcare provider, physician, or legal expert regarding dementia care, patient autonomy, or financial oversight.
The author and publisher assume no liability for actions taken based on the information provided herein.
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