Vulnerability, Law, and Dementia: An Interdisciplinary Discussion of Legislation and Practice

Titti Mattsson, Lottie Giertz


Legislation for dementia care needs to be continually rethought,
if the rights of older persons and other persons with dementia are
to be addressed properly. We propose a theoretical framework for
understanding vulnerability and dependency, which enables us to
problematize the currently prevailing legal conception of adults as
always able — irrespective of health or age — to act autonomously in
their everyday lives. Such an approach gives rise to difficult dilemmas
when persons with dementia are forced to make decisions on their
own about basic living conditions, such as housing and care, without
decision-making support. In Sweden, for example, such matters are
frequently left to the person him- or herself to decide, often without
any assistance from social workers, and with family members serving
as caregivers of last resort.
Using vulnerability theory as the framework for our discussion, we
argue that policymakers should not apply a group-oriented approach
(based on factors like age, legal status, or mental capacity) to persons
suffering from dementia. The needs of such individuals are as complex
and varied as they themselves are. We discuss our findings from an
interdisciplinary (law/social work) research project in which we
examine the dilemma that social workers face when they are required,
under the terms of the Swedish Social Services Act, to determine
whether persons with dementia are to be granted support.
We argue further that a cross-disciplinary approach — in which
vulnerability theory furnishes the framework — opens up for new ways
of understanding and developing social welfare law and practice.
This, we believe, can help us better address the rights, interests, and
needs of people with dementia, of their families, and of professionals
in the social welfare system. Finally, many of the problems faced by
ageing societies in general can be understood on the basis of such
an approach.

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