Refer to appendix 7 for a breakdown of the powers in the primary acts.

Case study 1 - Walter

Walter (49) has a learning disability (Downs Syndrome), asthma and heart disease and recently has shown symptoms of cognitive impairment. His memory is increasingly poor, he appears more stressed, has difficulty finding words at times, is disoriented and getting lost. His parents supported him until about a year ago, when they both died within weeks of each other. He was left a substantial amount of money. A care plan was introduced at the time, but Walter is often unwilling to go along with supports he once accepted. He is sometimes verbally aggressive to the care staff and can be physically intimidating. Walter's brother John is his is main family support. However, it is believed he is using Walter's cash to buy alcohol for his friends and uses Walter's house as a venue for drinking parties. John refuses staff access to Walter, only allowing entry to one support worker. Walter is also believed to be drinking excessively, has been seen disinhibited in public places and is paying little attention to self-care. Walter's GP suspects he is becoming incapable of understanding he needs support and treatment. Walter's house is now untidy and cans of lager litter the floor. He remains at home most of the time, because his asthma limits his ability to walk. He eats if his support worker helps him prepare food. There have been reports of John regularly accompanying Walter to a cash machine yet Walter cannot account for the money taken.

Case study 2 - Angus

Angus (75) gave his butchers business to his son Iain 10 years ago when his wife died. Iain is married with three children including a disabled daughter who requires a lot of support. In the last three years, Angus's physical and mental health has deteriorated markedly. A heavy smoker all of his life, he now has emphysema and he has suffered a series of strokes which have left him with difficulties in walking and caring for himself. He has also begun to be affected by the onset of dementia. Once a very astute businessman, who took a keen and active interest in politics, Angus is now frequently confused, disorientated and forgetful. Angus moved in with his son two years ago and has attended a day centre three days a week to give the family respite. He is resistant to this now however, often becoming upset and disorientated by the change of environment. The family is deeply upset that the necessary respite is failing. Angus is also now lapsing into Gaelic, the language of his younger days in Lewis. This upsets others who attend the day centre as they can't understand him. Angus often rejects his medication, which the family hides in his food. His son is stressed and anxious and has been heard shouting at Angus when he has been collected from the centre. Out of concern for all, the family has discussed the matter with Angus's social worker.

Case study 3 - Nancy

Nancy (73) has dementia, which has progressed significantly over the past year. Her husband looked after her until his recent death. Social work services are involved following a number of incidents where Nancy was found in the street at night, apparently returning to a previous home She has also invited people who have knocked on her door into her home. Neighbours find her partially dressed and often distressed when they visit. Their arrival can help her to be calmer. Some years ago, Nancy appointed her son as continuing and welfare power of attorney. He manages her financial affairs. A recent assessment concluded that she may benefit from moving into a residential setting. She enjoys company and her need for increased levels of care is growing. Nancy is apparently willing but her son refuses to consider her transfer to a care home. She has become distressed at not having money to spend when she goes out, and her financial contribution to care at home support has been stopped by her son.

Refer to Alzheimer Scotland's Charter of Rights for People with Dementia.

Case study 4 - Wilma

Wilma (72) has mild to moderate dementia, Chronic Obstructive Pulmonary Disease and heart disease. She is generally resistant to support. Her house is basically furnished and untidy. There is a smell of urine as Wilma is not continent during the night although she herself states she has no problems with going to the toilet or self-care. Wilma is thin and unkempt. She is fairly inactive and remains at home most of the time. She has no family support and says she is lonely most of time. She is constantly breathless and uses an oxygen concentrator. Wilma has a male friend, much younger than her, who generally visits her on Friday nights. Wilma has told carers that this man now wants to have sex with her and she says she is frightened of him but feels his company helps reduce her loneliness. She also thinks he wants money from her. She is fiercely independent, however, maintaining she has a choice in the matter and wants to continue to see him.

Refer to Alzheimer Scotland's Charter of Rights for People with Dementia.