People with learning difficulties and dementia should be given more of a say in decisions affecting their lives, a report says.

"Going with the Flow: Choice, Dementia and People with Learning Difficulties", commissioned by the Joseph Rowntree Foundation, examined the decision-making opportunities afforded to people with the two conditions.

It found that "little or no choice" was given to people with learning difficulties and dementia about where they lived, what they did during the day, or who supported them.

The researchers spent time with 20 people with learning difficulties who either had a diagnosis of, or were being assessed for dementia.

People with Down's Syndrome are more likely to develop dementia than someone who doesn't have the condition.

The disease is also more likely to develop with greater rapidity in people with Down's Syndrome.

They said: "People with learning difficulties are living longer and are also increasingly joining the growing numbers of people who have dementia.

"This trend throws up a range of issues for policy makers and practitioners.

"People with learning difficulties and dementia often have clear preferences. On a basis of this small-scale, in-depth study, the researchers conclude that those involved need to become more aware of this fact and more responsive to individuals' choices."

Call for training

They also said that more time should be devoted to bereaved people with the two conditions, and that the death of a loved one should be clearly explained.

The report recommends that carers should be given more training in dementia-related issues.

But the findings should be treated with some caution, said Professor Ben Sacks, of the Down's Syndrome Education Trust.

He stressed that every case should be looked at on an individual basis, and that involving people in decision making was only meaningful if they understood the consequences of their decision.

He said: "Alzheimer's is a progressive disease which goes through stages. At stage one, you may become forgetful with names and times, but you are able to take compensatory action like making notes to help you remember.

"By stage three, you are living in a perpetual present, because you have no memory at all.

"It would therefore not be meaningful to ask a person at this stage, whether they have Down's Syndrome or not, because they will not be capable of making an informed decision.

"They may be able to express a preference for a certain type of food, for example, but it is more of a reflex than a decision.

"The main thing is that you have to treat every single person, regardless of whatever syndrome they have, as individuals, and assess what each person individually is capable of."