Adults with Incapacity Flashcards
Who has capacity?
It is assumed everyone has capacity until proven otherwise - cant just look at someone and tell
The adults with incapacity act aims to do what?
aims to 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.
How is capacity defined?
Is defined as the ability to:
- receive impressions
- receive knowledge
- to do or understand something.
What is capacity important for?
- 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 what?
Negligence
What is the legal definition of incapacity?
The inability to enter into legally binding contracts
What does incapacity mean in terms of the AWI Act?
It means that the person is incapable of: • Acting • Making decisions • Communicating decisions • Understanding decisions • Retaining the memory of decisions
Does a lack of ability of communication mean that a patient has incapacity?
No - as long as the deficiency in communication can be made good by human or mechanical aid
(iPad, hearing aid etc.)
Note: NEVER assume that someone can’t communicate from first glance.
Is capacity and all or nothing scenario?
No
What is residual capacity?
Having the capacity to consent to some things but not others
e.g. o E.g. a patient with a learning disability may understand that they need to go to the dentist because they have a sore tooth or need a check-up. However, they may not be able to understand why they need certain treatments relating to this.
If you need a patient to demonstrate they have capacity, they should be able to what?
- Understand in simple language what the treatment is, its purpose and nature and why it is being proposed
- Understand its principal 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 (try leave for 24 hours)
What are the 5 key principles of the AWI Scotland Act?
- Treatment must benefit the patient
- Minimum necessary intervention (to get the patient comfortable)
- Take account of the wishes of the adult
- Consultation with relevant others
a. If you can’t figure out what the adult wants
b. Ask friends, family etc – what happened in the past with dental treatment? - Encourage the adult to exercise ‘residual capacity’
Principle 1 of the AWI Act is that the treatment must benefit the patient. How do you make sure that it benefits the patient in line with the act?
- Without the treatment that benefit would not be possible (and it will continue to get worse)
- Any intervention must improve or enhance their life (e.g. tooth out and can now eat)
We need to take into account the wishes of the patient (both present and past). How can we do this if the patient isnt able to communicate these?
- Any relatives or close friends
- medics
- primary carer
- any guardian or welfare power of attorney
What are the two different types of attorney’s?
- continuing power of attorney
- welfare power of attorney
