Is it possible to regain mental capacity following an Acquired Brain Injury?

Created: 7/22/2024

What is mental capacity?

Mental capacity is a term used to determine whether a person can make a particular decision, and it has been estimated that we make around 35000 conscious decisions each day!  That is a lot of decisions and a lot of brain work.  They are not all life-changing decisions, of course.  Some decision go almost unnoticed; what we wear, what we eat for breakfast, the route we drive to work or the shops, and the whether to risk stepping outside the door without a coat.  These are all decisions that we consciously make,  but typically spend little time considering and quickly forget about the decision making process. Other decisions are more significant, take a lot longer to decide and are far more memorable that what we might eat for breakfast.  Where we live, making high cost purchases, and whether to go ahead with a dental or medical procedure are just a few examples. Sometimes, people are unable to make decisions because of an illness or brain injury.  A person with advanced dementia, a person with a severe learning disability or a person who has experienced a recent injury to their brain, for example.  Where this is the case, it is important not to assume that the person cannot make any decision, just because they cannot make some decisions.  They may not be able to manage large sums of money and property that amount to millions of pounds, but may be able to manage a smaller budget and retain a degree of independence and autonomy. Health and social care professionals are usually very experienced in the assessment of mental capacity for a range of decisions.  Mental capacity assessment are reviewed periodically to ensure that the person continues to lack the mental capacity to make decisions.  Less common however, is the need to re-assess a person's mental capacity because it is suspected that they now have he mental capacity to make decisions.  This is often the case with people living with an Acquired Brain Injury (ABI) whereby over time they have regained the ability to make decisions, or people living with learning disabilities where they have received sufficient education in a particular matter to make the decision themselves.

How can a person with an Acquired Brain Injury (ABI) regain mental capacity?

One of the most satisfying aspects of being mental capacity assessors if the opportunities we have to assess whether a person has regained the ability to make decisions where they have been assessed to lack mental capacity previously.  In our experience, this often more often than not in the cases of people who have experienced an ABI.  Prior to working for Simply Social Work, our three most senior Social Workers all have experience working in acute hospitals and community rehabilitation units where people living with ABI have been treated and received rehabilitation.  They have seen first-hand how acute treatment and rehabilitation, and community rehabilitation have improved the lives of people living with an ABI. How, over time, their cognitive abilities as well as their physical abilities have significantly improved, unlike a progressive cognitive condition such as dementia.

Why is it important to determine whether a person has regained mental capacity?

Quite simply, because that is what the law requires.  A determination of a lack of capacity to make a specific decision should only be made for as long as is necessary.  Making a determination that a person lacks the mental capacity to make a specific decision when it is not correct, or forgetting to review such a determination and the person has regained the ability to make the decision can result in people being unnecessarily restricted from making their own decisions or an interference of their autonomy and freedoms.

How can we help determine whether a person has regained mental capacity?

We are not strangers to assessing people's mental capacity and have been making such determinations for several years.  Nor are we strangers to working with people living with the effects of an ABI of all ages.  We have assessed the mental capacity of teenagers involved in road traffic collisions and the mental capacity of nonagenarians who have experienced a recent stroke. As a team of Social Workers, we are familiar with the risks that people face on a daily basis and do not reach mental capacity determinations on risk alone; we use the correct test for each decision being assessed.