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Substantial difficulty

If a person is unable to do the following they will have substantial difficulty in engaging and being involved in care and support processes:

  • Not being able to understand relevant information for example if they have mid stage or advanced dementia
  • Not being able to retain information
  • Not being able to use or weigh up information for example, not being able to weigh up the advantages and disadvantages of moving into a care home.
  • Not being able to communicate your views, wishes and feelings.

For example, a person with advanced dementia, significant learning disabilities, a brain injury or mental ill health, a person with Asperger's, a frail older person who does not have a diagnosis but is confused as a result of an infection, or a person who is near the end of their life and appears disengaged from involvement and decision-making.‚Äč