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March 10, 2023

Book Review: Representing People With Dementia

David Godfrey

The entire PDF in which this article appears can be found here. 

Representing People With Dementia: A Practical Guide for Criminal Defense Lawyers

Edited by Elizabeth Kelley
$79.95 list $71.95 for ABA members
258 pages

Sooner or sooner or later your phone is going to ring with a client, or the family of a client, needing help with a criminal act committed by a person who is experiencing major neurocognitive decline caused by Alzheimer's or some other form of dementia.  I had a couple of those calls in my decade in civil legal aid.  I was not a criminal defense attorney, and many of the criminal defense attorneys we talked with lacked a working knowledge of how neurocognitive decline differs from mental illness. (Fortunately, both cases had a positive outcome for our client.)  This book would have been worth it’s weight in gold when those cases came in. 

The book is a collection of 16 chapters written by about two dozen national subject matter experts, with an introduction for each chapter written by the editor linking it all together into a coherent text.  Without trying to make the reader into a medical experts, the chapters explain what dementia is, and how it changes the judgement and behavior of an adult.  While Alzheimer’s disease is the most common cause of dementia, there are multiple other causes, some of them relatively rare, and each one changes the cognition and behavior of the person in different ways.  Some of the less common causes of dementia are more likely to be present in a person who is living with dementia and is a defendant in a criminal case. This basic overview will help a defense attorney better prepare for a vigorous defense, and be better prepared to question experts on the other side of the case.    

The book looks at common issues in these cases, such as fitness or competence to stand trial, defense based on lack of intent, defense based on insanity, and representing people on death row.  It talks about various experts that may be engaged by defense counsel, including consulting, and testifying experts.  There is a chapter talking about the harsh reality of life behind bars for a person living with dementia. 

Last summer the Commission on Law and Aging finished a research project looking at the experiences of persons with dementia in the criminal justice system, this book, written at the same time, reflects many of the same challenges that our research revealed. In addition, this book  goes much deeper into how to develop a defense strategy for a person living with dementia. One of the  recommendations of the research was training on dementia for professionals in the criminal justice system. This book would be an excellent resource in developing that training. 

Every criminal defense attorney needs to read this book as soon as possible.  Attorneys who work with clients at risk of dementia, or who are interested in dementia and the law would benefit from reading this book. The sections on less common causes of dementia, and how they are more likely to be present in a person who commits an act that is seen as criminal were enlightening. The discussion of testifying and consulting experts added new dimension to my understanding of trial strategy.  I hope you will find chapters that stand out and help you understand this complex issue from a new perspective.

David Godfrey, JD

Director, ABA Commission on Law and Aging

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