Mental Capacity Act and Capacity

Question 1

What is the Mental Capacity Act?

Answer 1

Legistaltion to protect and empower patients who may loack mental capacity to make their own decision about their care and treatment.
Came into force in 2007
Indicated in day to day tasks to complex clinical decisions like surgery
Often applied to conditions affecting cognition/communication such as stroke/brain injury

Question 2

When might the mental capacity act be used?
What is the test for this?

Answer 2

2 stage test
Does the person have an impairment of their mind o brain? Is this the result of an illness or external factors (alcohol etc)?
Does the impairment impact on the persons ability to make a specific decision at the time at which they need to?

Question 3

How do we know/test to see if someone has capacity to make a decision?

Answer 3

They can..
Understand relevant information
Retain info long enough to make decision
Use/weigh up information
Communicate their decision
Every reasonable adjustment must be made to make these possible

Question 4

What are the five key principles of the MCA?

Answer 4

1. Assume capacity until proven otherwise
2. Unwise decisions does not equal a lack of capacity
3. If lacks capacity decision should be made on their best behalf
4. If lacks capacity care should be as least restrictive of their rights and freedom as possible
5. Person should be helped in making their own decision whenever possible

Question 5

How can we help people make their own decisions with full capacity?

Answer 5

1. Give all info including alternatives.
2. Is dissucssion/presentation method appropriate e.g are visual aids needed
3. Is an advocate or family member available to help communicate if needed
4. Is understanding better at certain times of day or locations
5. Can the decision be delayed until the person is in a better state of mind

Question 6

What factors must be considered in best interest decision making?

Answer 6

Even if lacks capacity can the person be encouraged to help in the decision making process.
Any previous/present wishes or advanced planning or conversation with loved ones to help guide plan?
Any people we should consult such as Lasting Power of Attorney?
Ensure no assumptions are being made based on the persons age, condition or behaviour?

Question 7

How do we ensure the least restrictive option is followed in care planning for patients without capacity?

Answer 7

Is their an alternative option which interferes less with rights and freedom?
Does a DoLS need to be considered?
Do we need to act now or make a decision at all?

Question 8

What is a DoLS relating to capacity?

Answer 8

A Deprivation of Liberty Safeguarding Form.
Used when patients lack the capacity to make their own decision and consent to care
Enables decisions to be made on their behalf in their best interest
Often used to restrict patients freedom (which may misuse) in hospital or carehomes
Can prevent patients from leaving hospital, decide on location of care and routine.

Question 9

Define mental capacity

Answer 9

The ability to make and communicate an informed decision based on understanding the situation, options and consequences.
This applies to every decision at any level