Being Client-Centred When the Client is Cognitively Impaired

Abstract

Canadian occupational therapists aspire to be client-centred. As a profession we continue to debate what this means. The question of how to be client-centred becomes more acute when the client has cognitive deficits, and capacity, including the legal right to consent to treatment, is called into question. Further, in current literature and law, capacity is described as situational (i.e., specific to the time, circumstances and question being asked) and thus, difficult to determine. In this discussion, the author will explore two strategies, graded decision-making and advocacy, for practicing in a client-centred manner with cognitively impaired clients.