The Foundational Legal Framework: The Mental Capacity Act (MCA)
The Mental Capacity Act (MCA) is the cornerstone of Singapore's legislation concerning dementia and mental incapacity. Introduced in 2008 and implemented in 2010, the MCA provides a legal structure to protect individuals unable to make decisions due to cognitive impairment like dementia. It is designed to prioritize the individual's best interests while upholding their rights.
The Act is based on five key principles:
- Presumption of Capacity: Assume capacity until proven otherwise.
- All Practicable Steps: Help individuals make decisions before deeming them incapable.
- Not Unwise: An unwise decision doesn't automatically mean a lack of capacity.
- Best Interests: Decisions made for someone lacking capacity must be in their best interests.
- Less Restrictive: Actions should be the least restrictive of the person’s rights and freedom.
Planning Ahead with a Lasting Power of Attorney (LPA)
A proactive legal tool under the MCA is the Lasting Power of Attorney (LPA). This document permits a person (the 'donor') to appoint trusted individuals (the 'donees') to make decisions on their behalf if they lose mental capacity. An LPA offers assurance that a trusted person will manage affairs according to the donor’s wishes, avoiding court processes. To create an LPA, the donor must be at least 21 years old and possess mental capacity at the time of signing.
Scope of an LPA
An LPA can grant authority over two primary areas:
- Personal Welfare: Decisions regarding daily care, medical treatment, and living arrangements.
- Property and Affairs: Management of finances, including bank accounts, property, and investments.
Certain decisions, such as consenting to marriage or making an Advance Medical Directive, cannot be included in an LPA. The LPA is registered with the Office of the Public Guardian (OPG), an entity under the MCA that protects the interests of those lacking capacity.
When There is No LPA: The Court-Appointed Deputyship
If mental capacity is lost without an LPA in place, concerned parties can seek a court appointment as a 'deputy'. A court order grants the deputy legal authority for decision-making. This judicial process is typically more complex and costly than registering an LPA. The court defines the deputy's powers, guided by the MCA's five principles.
The Role of the Deputy
Deputies are overseen by the Office of the Public Guardian and must act in the best interests of the person lacking capacity. The OPG can investigate and intervene if there are concerns about abuse or mismanagement. Unlike the LPA, which is anticipatory, deputyship is a measure taken after mental capacity has been lost.
A Broader Support Ecosystem: Initiatives and Related Laws
Singapore’s approach to dementia care also includes a range of support initiatives, guided by the National Dementia Strategy (NDS). These include:
- Dementia-Friendly Singapore (DFSG): This movement fosters communities where people with dementia are supported. 'Go-To Points' offer assistance to those who are disoriented.
- National Dementia Strategy (NDS): This strategy informs the development of services, public awareness campaigns, and early diagnosis efforts.
- Vulnerable Adults Act (VAA): The VAA provides additional protections, allowing intervention in high-risk cases of abuse or neglect involving vulnerable adults, including those with severe dementia.
- CareShield Life and Long-Term Care Act: This legislation offers financial assistance to Singaporeans with severe disability, including dementia, to help with long-term care costs.
Comparison: LPA vs. Deputyship
| Feature | Lasting Power of Attorney (LPA) | Deputyship |
|---|---|---|
| Initiation | Appointed by the individual (donor) while they still have mental capacity. | Appointed by the court after an individual has lost mental capacity. |
| Timing | Proactive measure; done in advance of losing capacity. | Reactive measure; initiated after loss of capacity. |
| Choice of Decision-Maker | The individual chooses their own trusted donee(s). | The court appoints a suitable person(s) as deputy, usually a family member. |
| Scope of Decisions | Powers are specified and limited by the LPA document. | Powers are determined by the court order based on the individual's best interests. |
| Process | Simpler, involving an LPA certificate issuer and registration with the OPG. | More complex, involving a court application, potential hearing, and ongoing supervision. |
| Oversight | The Office of the Public Guardian oversees the donees and can investigate complaints. | Deputies are subject to ongoing court and OPG supervision, including annual reports. |
Conclusion
Singapore's legislative and support systems for individuals with dementia are designed to protect their rights and dignity. The Mental Capacity Act is central, providing for the proactive Lasting Power of Attorney and the reactive court-appointed Deputyship. These are complemented by initiatives like Dementia-Friendly Singapore and related laws such as the Vulnerable Adults Act. This comprehensive approach ensures legal protection and community support. Understanding these legal tools and support systems is essential for individuals and families planning for the future. The Ministry of Social and Family Development offers resources on these provisions via the Office of the Public Guardian website.
