Cutler Institute for Health and Social Policy

Providing Long Term Services & Supports to People with Impaired Decision-Making Capacity


When an individual’s ability to make decisions is impaired because of dementia, intellectual disability, brain injury, mental illness or another condition, respect for individual autonomy has to be balanced against the need to protect an individual from harm or exploitation. Decision-making capacity has important implications for Maine’s long term services and supports (LTSS) system. In 2011 in Maine, 17 percent of people receiving home care services, 56 percent of people receiving residential care services and 70 percent of nursing facility residents have either moderate or severely impaired decision-making capacity.

As the number of older adults and adults with disabilities grows, the prevalence of impaired decision-making capacity is also likely to grow. In this document we focus on two decision-making issues: the decision-making capacity necessary to maintain independence and live at home, and the decision-making capacity to provide informed consent.

This report provides analysis in narrative and chart form of the results of data analysis and interviews examining the needs and characteristics of persons with impaired decision-making capacity in Maine. Specifically, this report/chartbook: 

  • Reviews the prevalence of impaired decision-making capacity among adults and older adults receiving publicly funded home care services and supports in Maine, the characteristics of this population group, and the caregivers caring for persons with impaired decision-making capacity.
  • Reports on interviews with providers describing their ideas for helping people with impaired decision-making capacity live in the community longer.
  • Reviews the legal status of persons receiving long term services and supports in Maine, including the presence of a guardian or a Power of Attorney, among those with impaired decision-making capacity across settings.
  • Reports on interviews with providers, describing kinds of issues they encounter as they serve persons with impaired or deteriorating decision-making capacity.    

Suggested Citation:Griffin, E., Olsen, L., & Fralich, J. (2013, March). Providing long term services & supports to people with impaired decision-making capacity: Results of data analysis and interviews examining needs and characteristics of persons with impaired decision-making capacity in Maine.  Portland, ME: University of Southern Maine, Muskie School of Public Service.

This report was prepared for the Maine Department of Health and Human Services, Office of Aging and Disability Services.
Publication Type: 
Publish Date: 
March 1, 2013

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