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Special Care Dentistry > Disability and Legislation > Flashcards

Disability and Legislation Flashcards

1
Q

What is impairment?

A
  • Any loss or abnormality of psychological, physiological, or anatomical structure or function
  • Considered to occur at the level of the organ or system function

Example:
* Loss of leg movement after road traffic accident

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2
Q

What is disability?

A
  • Any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being
  • Disability is concerned with functional performance or activity, affecting the whole person
  • It is activity restricted by impairment

Example:
* No longer able to walk (require use of wheelchair)

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3
Q

What is handicap?

A
  • A disadvantage for a given individual, resulting from an impairment or a disability, that limits of prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual

Example:
* Not able to access non-wheelchair-friendly buildings

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4
Q

What does the equality act 2010 do?

A
  • The Equality Act 2010 legally protects people from discrimination in the workplace and in wider society
  • It provides a legal framework to protect the rights of individuals and advance equality of opportunity for all
  • It protects individuals from unfair treatment and promotes a fair and equal society
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5
Q

What are the protected characteristics?

A
  • Age
  • Disability
  • Gender reassignment
  • Marriage or civil partnership (in employment only)
  • Pregnancy and maternity
  • Race
  • Religion or belief
  • Sex
  • Sexual orientation
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6
Q

What are the types of discrimination within the act?

A
  • Direct discrimination: treating someone with a protected characteristic less favourably than others
  • Indirect discrimination: putting rules or arrangements in place that apply to everyone, but that puts someone with a protected characteristic at unfair disadvantage
  • Harassment: unwanted behaviour linked to a protected characteristic that violates someone’s dignity or creates an offensive environment for them
  • Victimisation: treating someone unfairly because they’ve complained about discrimination or harassment
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7
Q

When does the Act apply?

A
  • At work
  • In education
  • As a consumer
  • When using public services
  • When buying or renting property
  • As a member or guest of a private club or association
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8
Q

What is substantial and long term?

A
  • Substantial – means more than minor or trivial
  • Long-term – means that the effect of the impairment has lasted or is likely to last for at least 12 months (there are specific rules for recurring or fluctuating conditions)
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9
Q

What is the inverse care law?

A
  • Disadvantaged people need more health care than advantaged populations but receive less
  • Inverse Care Law is primarily about inequity in health care that results in unfair social inequalities in health
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10
Q

What is equity?

A

fairness

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11
Q

What do adults with intellectual disabilities have orally?

A
  • Higher levels of poor oral hygiene
  • High levels of gingivitis
  • Many affected by periodontitis and untreated dental decay
  • Unmet need relating to periodontal and tooth health, leading to tooth loss
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12
Q

What is being done to help those living in the most disadvantaged communities?

A

Oral Health Improvement Plan (2018)

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13
Q

What are the three situations where the duty on organisations to make reasonable adjustments arises?

A
  • Where a provision, criterion or practice applied by or on behalf of the employer
  • Where a physical feature of premises occupied by or on behalf of the employer, or
  • Where the lack of auxiliary aid,
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14
Q

What is the biopsychosocial model?

A

General acceptance that illness and health are the result of an interaction between biological, psychological, and social factors.

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15
Q

What are the active barriers to dental care in older people?

A
  • Cost and Fear of Cost
  • Fear (Dental Anxiety)
  • Accessibility
  • Availability (NHS to Private – 2008)
  • Characteristics of Dentist – Personality, Polite and Professional, perception of Service NHS vs. Private
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16
Q

What are the direct and indirect financial barriers for patients?

A

direct - cost of treatment
indirect - travel, carers

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17
Q

What are the barriers to oral hygiene for older people who are dependent?

What are the facilitators?

A

barriers - lack of knowledge, refusing care
facilitators - BOHC training/education, presence of a dental professional

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18
Q

What are the barriers to treatment for older people who are dependent?

what are the facilitators

A

barriers - lack of suitable facilities for treatment, transportation of patients
facilitators - regular visiting dentist routine assessment/increased awareness by staff

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19
Q

What are the characteristcs of sedation as a adjuvant therapy?

A
  • limited in general dental servcies
  • case complexity
  • techniques available
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20
Q

What are the characteristcs of GA as a adjuvant therapy?

A
  • varies by region
  • number of lists
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21
Q

What are individual level barriers for medically complex patients?

A

may not tolerate some procedures and find oral hygiene difficult

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22
Q

What are organisation level barriers for medically complex patients?

A
  • Administratively difficult to manage care of these patients
  • Numbers of patients exceeds capacity of services available
  • Health professionals unaware of dental consequences of medical treatment
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23
Q

What individual-level barriers do people with mental health conditions face in accessing oral healthcare?

A

Feelings of shame, guilt, stigma, helplessness, and low self-esteem.
Confusion and lack of recall of conversations.
Perception of public services as inadequate.

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24
Q

What organisational-level barriers exist for people with mental health conditions in oral healthcare?

A
  • Lack of protocols.
  • Limited staff time.
  • General dentists’ unwillingness to treat patients with complex mental health needs.
  • Limited specialised expertise for high treatment needs.”
25
Q

What policy-level barriers impact oral healthcare for individuals with mental health conditions?

A

Service organisation issues as mental health care transitions from institutional to community living.

Limited resources prioritised for other populations.

26
Q

What are the main barriers to dental treatment for patients with hereditary bleeding disorders in the West of Scotland?

A

Travel: Challenges include flights, overnight stays, and ambulance transport.
Entry to department: Requires parking access, lifts, or ground floor entry, and hoists.
Dental treatment: Specialized units with medical input are necessary.

26
Q

What are the key facilitators for improving oral health care in people with mental illness?

A
  1. Education and training for dental professionals.
  2. Financial support for treatment.
  3. Improved dentist-patient communication.
  4. Interprofessional collaboration and community support.
27
Q

What are the observed disparities in the distribution of NHS dental practices across the UK?

A

Scotland, Wales, and Northern Ireland show NHS dental practices are not socioeconomically distributed.

England demonstrates disparities requiring increased spatial availability of dental services.

28
Q

Define oral health literacy (OHL) and its impact on oral health outcomes.

A

Definition: The capacity to obtain, process, and understand oral health information for informed health decisions.
Impact: Low OHL correlates with poor oral health due to misunderstanding dental instructions and maintenance difficulties.

29
Q

Identify key barriers to effective communication between dental providers and patients.

A

Limited time for consultations.
Financial models prioritizing treatment over prevention.
Lack of plain-language materials and oral health literacy (OHL) training.
Patients’ limited knowledge of oral health.

30
Q

How can system navigation programs improve healthcare outcomes for complex cases?

A
  1. Enhancing access to primary healthcare instead of costlier emergency care.
  2. Providing team-based navigation to coordinate siloed services.
  3. Improving patient confidence in navigating healthcare systems.
31
Q

What is the Common Risk Factor Approach in oral health?

A

Focuses on shared risk factors (e.g., diet, hygiene, and lifestyle) that influence multiple diseases, making prevention more holistic and effective.

32
Q

What unique barriers do individuals with autism face in oral health care?

A

Behavioral: Oral aversion, food selectivity, and resistance to conditioning.
Communication: Difficulty expressing pain and understanding health needs.
Environment: Sensory sensitivities to visual, auditory, and tactile stimuli in clinical settings.

33
Q

What organisational-level barriers affect oral healthcare for patients with learning disabilities?

A

Dentists are unwilling or lack experience to treat these patients.
Shortage of specialised dental professionals.
Policy issues related to transitioning from institutional to community care.

34
Q

What workforce challenges exist in addressing oral health needs for vulnerable populations?

A

Insufficient availability of dental care professionals across all tiers.
Lack of collaboration between dentistry and medical disciplines (e.g., psychiatry).

35
Q

Why is transitional care critical for adults with intellectual disabilities?

A

To prevent oral health deterioration that often occurs when transitioning from childhood to adulthood due to inadequate continued care.

36
Q

What are the five domains to overcome barriers?

A

Availability
Accessibility
Accommodation
Acceptability
Affordability

37
Q

What is an advocate and when are they helpful?

A

Everyone has the right to get support from another person to help express their views and wishes
* This person is called an advocate
* Advocates can be helpful when people:
* Find it difficult to make their own views and wishes known * Need to have their views and wishes taken into account

38
Q

What act safeguards the welfare and manages the finances of people agd 16 and above who lack capacity?

A

adults with incapacity (scotland) act 2000

39
Q

What are the 5 key principles of incapacity act?

A

benefit
least restrictive of freedom
the person’s past and present WISHES should be taken into account
consult relevant others
encourage residual capacity

40
Q

What does being capable mean?

A

making a descision
understanding the decision
communicating that decicion
retaining memory of that decision

41
Q

What are the 3 types of proxy?

A
  • Power of Attorney
  • Guardian
  • Intervener
42
Q

What is a POA?

A
  • Granted by the adult whilst he/she still has capacity
  • Certified by lawyer or medical practitioner
  • Continuing power of attorney – only covers financial affairs and property
  • Welfare power of attorney – matters relating to health and personal welfare * Joint power of attorney – covers both continuing and welfare powers
43
Q

What is a guardian?

A
  • Court appointed
  • Require 2 medical reports
  • Powers to deal with property, finance and health matters
  • Time limited
44
Q

Who is an intervener?

A

Usually appointed for a one-off event, not common in dentistry

45
Q

Who can consent for dental treatment?

A
  • Patients with capacity
  • Welfare Power of Attorneys
  • Welfare Guardians
  • Medical and dental practitioners (who have undergone further training) can authorise treatment under Section 47 of the AWI Act
  • A dentist can only authorise dental treatment
46
Q

When should a section 47 certificate be issued?

A
  • If a patient is incapable and has a Proxy: seek consent from Proxy and have Section 47 certificate issued
  • If a patient is incapable and DOES NOT have a Proxy: have Section 47 certificate issued
  • Section 47 certificates must always be issued in accordance with 5 key principles
47
Q

What is the patient rights act 2011?

A
  • Supports the Scottish Government’s plans for a high-quality NHS that respects the rights of patients as well as their carers and those who deliver NHS services
  • The Act gives everyone the right to receive healthcare that:
  • Considers their needs
  • Considers what would most benefit their health and wellbeing; and
  • Encourages them to take part in decision about their health and wellbeing, and gives them information and support to do so
  • It supports a person-centred NHS
48
Q

What was included in the patient’s rights act?

A
  • Included in the Act was the establishment of a Patient Advice and Support Service (PASS) which provides free, accessible and confidential information, advice and support to patients, their carers and families about NHS healthcare
49
Q

What is the mental health act 2003?

A
  • Increases the rights and protection of people with mental disorders, which encompasses people with mental illness, learning disability and personality disorder
  • The Act places duties on local councils to provide care and support for people with mental disorders
  • The provisions of the Act are intended to ensure that care and compulsory measures of detention can be used only when there is a significant risk to the safety or welfare of the patient or other people
50
Q

What is emergency dententon?

A
  • Allows a person to be held in hospital for up to 72 hours while their condition is assessed
  • Can only take place when recommended by a doctor
  • Where possible, a mental health officer should also agree to it
51
Q

What is short term detention?

A
  • More safeguards for the individual
  • Recommended by a psychiatrist and mental health officer * The named person should be consulted
  • Authorises a 28-day detention period
52
Q
A
53
Q

What is a complusory treatment order?

A
  • Can last up to 6 months (and can then be extended)
  • Mental Health Tribunal (made up of a lawyer, psychiatrist and another person with relevant skills and experience) decides whether CTO is granted and where treatment will be ie in hospital or in the community
54
Q

What is the 3 points for a adult to be considered at risk?

A

1) Unable to safeguard their own well-being, property, rights or other interests
2) At risk of harm
3) Because of disability; mental disorder; illness or physical or mental infirmity to being so harmed than a person not so affected.
* The presence of a condition does not make someone at risk

55
Q

What is the purpose of the adult support and protection act 2007?

A

“The Act introduced provisions intended to protect those adults who are unable to safeguard their own interests, who are at risk of harm and, because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to harm than those who are not so affected”

56
Q

What is the triangle of legislation?

A

adult support and protection act 2007
mental health 2003
adults with incapacity act 2000

scotland

57
Q

What is the legislation in england and wales?

A

Mental Capacity Act 2005 provides a legal framework for acting and making decisions on behalf of adults who lack capacity

58
Q

What is the legislation in northern ireland?

A
  • Mental Capacity Act (Northern Ireland) 2016 fuses together mental capacity and mental health law for those aged 16 years old and over within a single piece of legislation
  • Disability Discrimination Act 1995 remains in NI (replaced in Scotland, England and Wales by the Equality Act 2010)

Special Care Dentistry (7 decks)

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