The Right to Refuse: Ethical Issues in Capacity Assessment for Older Adults With Aphasia and Possible Dementia

Cerebrovascular accident is a common diagnosis in the rehabilitation and long-term care setting and can be associated with deficits in both language and cognition. Because capacity assessment requires a patient to both understand the decision in question and express a choice, it can be particularly challenging to determine capacity in patients with aphasia. Complex medical decision-making and use of healthcare proxies in this setting require careful navigation of patient needs, goals, and rights.