capacity Flashcards
What is the Adults with Incapacity Act
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
The Act 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
When does the Adults with Incapacity (Scotland) Act 2000 come into action
where an adult is incapable of making a decision for themselves
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
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
What is residual capacity
our residual functional capacity is the most you can still do despite your limitations
How would you assess capacity
Keep language appropriate
Break up information into sections
Ask the patient to explain to you what you have discussed with them (check)
Assess retention – ask the patient at another appointment
Seek advice when needed
Be open minded and methodical
Who may not have capacity
If a patient has a “mental disorder” – mental illness, learning disability, dementia, acquired brain injury, autistic spectrum disorder
If a person cannot communicate due to a physical disorder even with assistance – locked in syndrome, unconscious following an accident
Adults with incapacity (Scotland) 2000 states that for a person to be unable to make a descion in relation to their treatment they have to be incaple of 1 or more of what:
Being incapable of:
-Acting
-Making a decision
-Communicating decision
-Understanding decision
-Retaining the memory of decision
What does AMCUR stand for
Acting
Making a descion
Communicating decision
Understanding decision
Retaining the memory of decision
Why is communication so important
A person CANNOT be considered to be lacking capacity because of a lack or deficiency in communication
Ask how they communicate
To demonstrate capacity individuals should be able to do what
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
What are the principles of the adults with incapacity(AWI) act
1) Benefit
Any action or decisions taken must benefit the adult and only be taken when that benefit cannot reasonably be achieved without it, any intervention must improve there life
2) Minimum necessary intervention (least restrictive option)
Any action or decision taken should be the minimum necessary to achieve the purpose,It should be the option that restricts the person’s freedom as little as possible, must always seek to avoid the most invasive treatments, when simpler alternatives are available and likely to be successful
SHOULD NOT MEAN SIMPLEST OR LEAST COMPLEX SOLUTION
3) Take account of the wishes of the adult
We must try and find out what the patient previously (or currently) wanted regarding their dental treatment, ask family or close friends and patient
4) Consultation with relevant others
The patient’s family, friends, primary carer, guardian, attorney or other people of relevance are likely to know the person much better, relevant others should be consulted with regard to what they think that the patient would have wanted
5) Encourage the adult to exercise ‘residual capacity’
Identify if there are any decisions which the patient can make for themselves.
In so far as it is reasonable or practicable to do so, encourage the adult to exercise whatever skills he or she has concerning property, financial affairs or personal welfare as the case may be, and to develop new such skills
What is a proxy for someone not with capacity
A person authorised under an intervention order with power in relation to any medical Tx can be called a proxy
Any person who is a proxy should have appropriate documentation
Important to ensure:
A) the proxy has correct documentation
B) Its in date
What is power of attorney
Under scots law any person who has capacity can permit a nominated person person they trust to act as there continuing or welfare POA
These are granted while a patient has capacity for someone to act on their behalf should the need arise
Powers are dormant until demonstrated they are needed
No expiry date
This can be done via a lawyer and does not need to go to court
What are the 3 types of power of attorney
Continuing
Welfare
Combined
