07 September 2009The story of Mary illustrates the complexity of making decisions for other people, writes John Chesterman in The Age

MARY IS AN ELDERLY woman with Alzheimer's disease and some other minor health problems. She lives alone and gets by with the help of the local council's ''meals on wheels'' and her neighbours. Her cognitive abilities are declining, and some mild delusional thoughts have led her to make occasional threatening outbursts. After an admission to hospital, Mary's doctor decides to make a guardianship application, taking the view that Mary is no longer able to look after herself or make significant decisions. With no close friends or relatives, the Public Advocate is appointed as Mary's guardian, removing Mary's right to decide where, and with whom, she lives.

Mary's guardian has to balance up several considerations in working out where Mary should live. Foremost among these are her wishes and wellbeing, two factors that ordinarily run together but, where cognitive decline is concerned, sometimes don't. Mary wants to stay in her own home with her dog, but her health is clearly deteriorating...

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John Chesterman is manager of policy and education at the Office of the Public Advocate. ''Mary'' is a pseudonym.

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