People with dementia can experience behavioural changes such as disinhibition, loss of empathy and agitation, as well as cognitive impairment leading to impaired judgement and poor decision-making. In a proportion of cases these can lead to behavioural aberrations that may be perceived as criminal offending, despite lacking criminal intent. Examples include dangerous driving, verbal and physical abuse, socially inappropriate behaviour and sexual transgressions. Our research suggests that such behaviours may occur in as many as 40% of people with dementia, creating risks of interactions with law enforcement and the legal system. This session will outline the nature and prevalence of criminal risk behaviours in dementia syndromes. The clinical phenotype and underlying mechanisms will be discussed. These will be integrated with illustrative case examples. The second half of the session will focus on appropriate management from a clinical perspective, as well as highlighting relevant legal issues for clinicians to be aware of. These issues will be considered across the disease trajectory, from pre-diagnosis when alleged criminal behaviours may be a red flag for considering dementia diagnosis, through to strategies to enable people with dementia to avoid inappropriate interactions with the criminal legal system.
Fiona Kumfor is an Associate Professor and Clinical Neuropsychologist in the School of Psychology, University of Sydney. She has received >$5.2 million in competitive funding and has published >100 peer reviewed publications in leading journals such as Lancet Neurology, Brain, Cortex and Journal of Neurology, Neurosurgery and Psychiatry. Her research has been instrumental in delineating social cognition and behavioural profiles across frontotemporal dementia syndromes, and developing psychosocial interventions to improve quality of life in patients and their carers. In 2023 she co-founded the Dementia Law Network, which is a multidisciplinary group focused on issues at the intersection of dementia and the law.
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