[Social competence and ability to make decisions].

Social competence and judgement can be separated in a somatic and in a mental competence. In mental competence, the capacity to consent has to be distinguished from the capacity to judge legal or more complex matters. Autonomy of patients requests that the capacity of consent is given, even in the presence of considerable cognitive impairment. On the other hand, competence in legal matters may be not any longer given in the presence of light to moderate cognitive impairment. In the assessment of competence, it is important that the person has the ability to make a choice, the ability to give directives, and the ability to do for oneself. Cognitively impaired patients therefore require assistance and protection in legal matters already at an early stage of the disease.