Dementia Directive (Nigeria)

A Dementia Directive in Nigeria records a person's instructions for their future medical care should they lose capacity to decide.

Nigeria does not yet have a dedicated national statute governing advance directives or advance care planning in the way that several countries (such as the United Kingdom under the Mental Capacity Act 2005) have codified these documents. However, the legal basis for respecting a person's advance healthcare decisions in Nigeria derives from several sources: the constitutional right to dignity of the human person under Section 34 of the Constitution of the Federal Republic of Nigeria 1999 (as amended); the right to private and family life under Section 37; and the common law principle of patient autonomy recognised by Nigerian courts, which requires informed consent to medical treatment.

The National Health Act 2014 (NHA) — Nigeria's principal health sector legislation — addresses consent to medical treatment under Section 23, which provides that healthcare providers must obtain consent from patients and that where a patient cannot consent (due to incapacity), consent may be given by the next of kin or legal guardian. A Dementia Directive supplements these provisions by recording in advance what the patient's own wishes would be, guiding both family members and healthcare providers.

In practical terms, a Dementia Directive is typically used alongside a Power of Attorney (specifically, a Lasting or Enduring Power of Attorney authorising an attorney to make healthcare and property decisions on the grantor's behalf) to form a thorough incapacity planning package. Nigerian hospitals and care facilities — particularly private hospitals and nursing homes in Lagos, Abuja, and Port Harcourt — are increasingly aware of advance directives as part of patient-centred care standards promoted by the Medical and Dental Council of Nigeria (MDCN).

The legal framework governing the Dementia Directive (Nigeria) in Nigeria draws on several key statutes and regulatory bodies. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Parties executing a Dementia Directive (Nigeria) in Nigeria should confirm the document reflects current law, including any amendments enacted since the original drafting date. The National Health Act 2014 sets the foundational requirements.

A Dementia Directive is needed in Nigeria by any adult who wishes to document their healthcare preferences and values in advance, so that those preferences guide their care if they lose mental capacity.

A Dementia Directive is required when an individual receives an early diagnosis of Alzheimer's disease or another form of dementia and wishes to record their treatment preferences — including preferences about hospital admission, medication, resuscitation, and end-of-life care — while they still have full capacity to make those decisions.

A Dementia Directive is needed when an elderly individual wishes to plan ahead for the possibility of cognitive decline, documenting their preferences about residential versus home care, preferred medical facilities (such as specific Lagos or Abuja hospitals), dietary and religious preferences, and social activities that are important to their wellbeing.

A Dementia Directive is required when a family member is concerned about future disputes between family members over the care of an elderly relative, and the relative wishes to record their own clear preferences to guide decision-making and reduce the scope for family conflict.

A Dementia Directive is needed as part of a thorough estate and incapacity planning package — alongside a Will, a Power of Attorney, and possibly a Living Will — for any individual who wishes to confirm their affairs are managed according to their own values and preferences if they lose capacity.

A Dementia Directive is used by medical professionals in Nigeria who wish to document their own healthcare preferences (including Do-Not-Resuscitate instructions) in a way that their colleagues and family can rely on, given their professional understanding of the treatment implications.

Parties in Nigeria should prepare a Dementia Directive (Nigeria) proactively rather than waiting for a dispute to arise. Courts interpret agreements based on the written terms rather than oral representations. Under Nigerian law, the Companies and Allied Matters Act 2020 (CAMA) regulates corporate entities through the Corporate Affairs Commission (CAC). The Labour Act (Cap L1 LFN 2004) and the National Industrial Court of Nigeria (NICN) govern employment disputes. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) protect personal data. The Federal Inland Revenue Service (FIRS) administers tax obligations under the Companies Income Tax Act. The Federal High Court and state High Courts have jurisdiction over civil matters. Where the transaction involves regulated activities, prior approval from the relevant authority may be required before execution.

A Dementia Directive for Nigeria should include the following essential elements.

Personal Details: Full name, date of birth, residential address, National Identity Number (NIN) issued by the National Identity Management Commission (NIMC) under the NIMC Act 2007, and contact details of the person making the directive. The NIN enables healthcare providers and attorneys to verify identity when acting on the directive.

Capacity Statement: A declaration that the person is making the directive freely and voluntarily while of full mental capacity, and that they understand the nature and effect of the document. This capacity declaration is critical because Nigeria's constitutional right to dignity of the human person under Section 34 of the Constitution of the Federal Republic of Nigeria 1999 (as amended) requires that advance directives be made autonomously and without undue influence.

Named Persons: The names, addresses, and contact details of the person's attorney (if a Power of Attorney has been executed under the Powers of Attorney Act Cap. P12 LFN 2004), next of kin, and any specific healthcare professionals registered with the Medical and Dental Council of Nigeria (MDCN) or nursing homes that the person trusts.

Medical Treatment Preferences: Specific instructions about preferences for or against particular treatments — including hospital admission, cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, antibiotics for infections, pain management through palliative care, and end-of-life hospice care. The National Health Act 2014 (Section 23) requires healthcare providers to seek consent to treatment; the directive supplies this consent framework when the patient can no longer communicate directly.

Personal Care Preferences: Preferences about living arrangements (home care, family care, nursing home), daily routines, dietary requirements consistent with personal or religious beliefs (including dietary requirements under Islamic or Christian traditions relevant in northern and southern Nigeria respectively), language of communication, and social activities that are important to wellbeing.

Financial Management: Whether the person has executed an Enduring or Durable Power of Attorney covering financial affairs under the Powers of Attorney Act Cap. P12 LFN 2004, the name and contact details of their attorney, and instructions directing carers and family to the attorney for financial decisions affecting bank accounts held at Central Bank of Nigeria (CBN)-licensed institutions and property under the Land Use Act 1978.

Do Not Resuscitate (DNR): Whether the person wishes to issue a DNR instruction for specific clinical scenarios, and any conditions. DNR instructions should be discussed with a MDCN-registered physician to confirm clinical appropriateness.

Review Date: A scheduled review date — typically every two to three years or after a significant health event — at which the person, while still capacitous, should confirm or update the directive.

Execution and Witnessing: Signature of the person and two independent witnesses (who are not family members, potential beneficiaries, or named attorneys), ideally sworn before a Commissioner for Oaths or Notary Public to strengthen enforceability. The Nigeria Data Protection Regulation (NDPR) 2019 and the Nigeria Data Protection Commission (NDPC) require that health and personal data in the directive be protected and only shared with authorised persons. Forms-legal.com provides this Dementia Directive template as a starting point for Nigeria-compliant incapacity planning documentation.