Adults with incapacity Flashcards
Why must we never assume people are incapable?
- Everyone should be treated equally
- Everyone should be assumed to have capacity unless proven otherwise
- Responsibility upon healthcare practitioners to assess capacity
- For those who lack capacity, care must be facilitated to ensure equality in the provision of care.
In Scottish Law when can you make legally binding decisions for yourself?
- 16
- Consenting to medical and dental treatment as an example of exercising your legal capacity
What is the Adults with Incapacity Act 2010?
- A framework for safeguarding the welfare and managing the finances of adults who lack capacity due to mental illness, learning disability or a related condition, or an inability to communicate
What is the aim of Adults with Incapacity Act 2010?
- Protect people who lack capacity to make particular decisions, but also to support their involvement in making decisions about their own lives as far as they are able to do so.
What is the Adults with Incapacity (Scotland) Act 2000?
- Only comes into action where adult is incapable of making decisions themselves
- Provides a range of ways to authorise someone else to make the decision for that incapable adult
- Only applicable to Scotland – Ireland, Wales and England are different
- Part 5 of the act covers medical (including dental) treatment
- Allows the Sheriff court to appoint guardians; oversee attorneys and resolve disputes
What do we always assume about an individual?
- Everyone has capacity until proven otherwise
Why is capacity important?
- Decision making - capacity is key to autonomy
- Everyone has the right to say what happens to their body
- Everyone also has the right to say what they don’t want to happen to their body
- In terms of healthcare, competent adults have the right to refuse treatment
- Failure to treat adults who do not have capacity may constitute negligence
What is the legal definition of Incapacity?
- Inability of an adult to enter into legally binding contracts
- “Adult” means a person who has attained the age of 16yrs or older
- An adult with a condition, to the extent that they cannot understand what a decision involves or make a true choice
- If a person with incapacity makes a decision – it has no legal effect
Who may not have Capacity?
- If patient has ‘mental disorder’ (mental illness, learning disability, dementia, acquired brain injury, autistic spectrum disorder)
- If person can’t communicate due to physical disorder even with assistance (locked in syndrome, unconscious following an accident)
What is the Acronym of being incapable?
A - Acting
M - Making a decision
C - Communicating decision
U - Understanding decision
R - Retaining memory of decision
What can we not assume if person lacks or is deficient in communication?
- Can’t be considered lacking capacity if the lack or deficiency can be made good by human or medical aid
- Need to support person to maximise their communication
How to achieve best communication with individual that’s lacking or deficient in this?
- Find out how the person communicates – ask!!!
- Check if they are wearing or have with them their normal aids
- Ensure a quiet, well lit environment
- Allow adequate time
- Use technology – loop systems, spelling boards, ipad…
- Consider communication adjuncts
What are the 5 key Principles of Adults with Incapacity Act?
- Benefit
- Minimum necessary intervention
- Take account of the wishes of the adult
- Consultation with relevant others
- Encourage the adult to exercise ‘residual capacity’
What should individuals be able to do to demonstrate capacity?
- Understand in simple language what the treatment is, its purpose and nature and why it is being proposed
- Understand its principle benefits, risks and alternatives;
- Understand in broad terms what will be the consequences of not receiving the proposed treatment
- Retain the information long enough to use it and weigh it in the balance in order to arrive at a decision
(Scotland – “retain the memory of the decision”)
What is meant by benefit of patient in AWIA principle?
- Any treatment must benefit the patient
- Without treatment that benefit would not be possible
- Any intervention must improve or enhance their life
