10 - Older Person's Mental Health Flashcards
What is the difference between implied and expressed consent?
- Expressed is written or oral
- Implied is ambiguous e.g nodding, turning up for surgery on time, rolling up sleeve for blood test
What is the definition of mental capacity?
One’s own ability to make decisions e.g personal welfare, healthcare, financial
It is time specific and decision specific
What are the 5 principles of the MCA 2005?
- Assume everyone has capacity until proven otherwise
- Provide information in all sources to help aid capacity
- Unwise decision doesn’t mean somebody lacks capacity
- Best interests
- Least restrictive
What are some scenarios where someone may lack capacity?
- Stroke or brain injury
- Mental health problem
- Dementia
- Learning disability
- Confusion, drowsiness or unconsciousness
- Substance misuse
Always reassess as time and decision specific
What is the two stage capacity test?
Stage 1 - Is the person unable to make a particular decision? (Diagnostic)
Stage 2 - Is the inability to make a decision caused by an impairment of, or disturbance in the functioning of, a person’s mind or brain? e.g mental illness, dementia, or learning disability, or more temporary states such as confusion, unconsciousness, or the effects of drugs or alcohol. 4 test!!!!(Functional)
What is the definition of the following:
- LPA
- Deputies appointed by the Court of Protection
- Public Guardian
- IMCA
- LPA: Person appointed by pt when they have capacity to make decisions for them when they no longer have capacity
- Deputies appointed by the Court of Protection: Person appointed once the person has already lost capacity so cannot nominate a LPA. Could be friend, family or solicitor. Can have one deputy for finances/property and one about personal welfare. Not able to make healthcare decisions like LPA can
- Public Guardian: A person who polices LPAs and Deputies to stop them from financially abusing the person who lacks mental capacity
- IMCA: When somebody lacks capacity so needs a best interest decision but there is no family/friends for doctors to consult with about the best interest
What is a IMHA?
Independent Mental Health Advocate
Statutory right for people detained under most sections of the Mental Health Act, subject to Guardianship or on a community treatment order (CTO)
IMHAs help the patient get their opinions heard and help them to know their rights as per the law
What is DoLS being replaced by?
Deprivation of Liberty Safeguard is going to be replaced by Liberty Protection Safeguards (LPS) in 2022
What settings can DOLS be used in?
- Hospitals
- Care homes
Can only use restraints and restrictions when this is in place and should only be used when in somebody’s best interest
Should not place anybody under this if they can be held under the MHA
How is a DoLS applied for?
Must request standard authorisation from local authority
What is the definition of a mental disorder?
A behavioral or mental pattern that causes significant distress or impairment of personal functioning
What is the purpose of the following sections in the Mental Health Act 1983/2007, who can enforce it and how long does the section last for:
Section 2
Purpose: Allow a person to be detained in hospital for assessment, ADMISSION FOR ASSESSMENT, cannot be extended
Who can enforce it: AMHP + 2 Doctors (one of them being section 12 approved)
Duration: 28 days
What is the purpose of the following sections in the Mental Health Act 1983/2007, who can enforce it and how long does the section last for:
Section 3
Purpose: Admission for treatment, can be extended
Who can enforce: AHMP + 2 Doctors (one is section 12 approved and has experience with treatment of condition)
Duration: 6 months but can be extended
What is the purpose of the following sections in the Mental Health Act 1983/2007, who can enforce it and how long does the section last for:
CTO
Purpose: Supervised treatment in the community following being detained under a section in hospital. Can return you to hospital immediately for treatment if need be
Who can enforce: Responsible Clinician
How long: 6 months, can be extended
What is the purpose of the following sections in the Mental Health Act 1983/2007, who can enforce it and how long does the section last for:
Section 5 (4)
Purpose: Nurse’s holding power to hold you there until you can be assessed by a doctor, the doctor can then decide to end your section or start another
Who can enforce: Nurse
How long: 6 hours