Carers, companions, consent and privacy

Carers, relatives and companions often provide practical help in optical care - travel, memory prompts, communication, history, payments, frame choices, aftercare and appointments. Wherever possible keep the person with dementia at the centre of interactions.

A diagnosis of dementia does not automatically remove a person's right to make decisions or control information. Support staff should speak directly to the patient, ask what help they want, and follow local procedures when someone else requests information or seeks to make decisions.

Working well with companions

• Address the patient first: do not speak only to the companion unless the patient asks you to.
• Ask what support is wanted: clarify whether the companion will help with memory, transport, communication or payment.
• Protect privacy: relatives do not automatically have a right to results, records, appointment details or costs.
• Watch for pressure: a companion may assist but can also speak over or pressure the patient.
• Use factual notes: record who attended, what was agreed and any concerns according to local procedure.
• Escalate uncertainty: involve a registrant or manager if consent, capacity, legal authority or safeguarding is unclear.

Capacity concerns

Capacity is specific to the decision and may fluctuate. Support staff must not make complex capacity determinations alone. Help the person to understand information, avoid rushing them, respect clear choices, and seek advice when the person cannot understand, retain, weigh or communicate a decision for the matter in hand.

Capacity, confidentiality and national differences

Companions can support care, but dementia does not make the patient invisible. Speak to the person, protect privacy and escalate uncertainty.