older person mental health

Question 1

scales used to assess cognitive impairment

Answer 1

MOCA - montreal cognitive assessment

oxford cog screen

addenbrooke cognitive screen

Question 2

what does a draw clock test for

Answer 2

executive function

Question 3

what aspects are assessed in a cognitive assessment

Answer 3

attention
memory
fluency
language
visuospatial

Question 4

what are the 5 core principles of MCA

Answer 4

Presumption of capacity

All practicable steps

Unwise decisions

Best Interests

Least restrictive

Question 5

what is deprivation of liberty safeguard (DoLS)

Answer 5

Make sure people who are in care homes/hospitals and supported living who lack capacity are looked after in way that does not appropriately restrict their freedom - this is an essential human right

If someone lacks capacity and/or risks being deprived of their liberty they must apply for a DOLs authorisation

Question 6

how do you test if someone is being deprived of their liberty

Answer 6

acid test

Is the person subject to continuous supervision and control

Is the person free to leave

Question 7

example of someone who is deprived of their liberty

Answer 7

If a person is supervised continuously and is not free to leave they are almost certainly being deprived of their liberty

Sedation/medication use; Physical restraint ; Objections from family ; Unstable placemtn

Question 8

what is diogenes syndrome

Answer 8

senile squalor

primary or secondary

Question 9

primary cause of diogenes

Answer 9

personality abnormality and impact of ageing ,loss events and physical disability.

Question 10

secondary causes of diogenes

Answer 10

presence of a mental disorder – Frontal Lobe , Depression ,OCD, Dementia

Question 11

what is the two step capacity test for mental act

Answer 11

The MCA sets out a 2-stage test of capacity:
1) Does the person have an impairment of their mind or brain, whether as a result of an illness, or external factors such as alcohol or drug use?

2) Does the impairment mean the person is unable to make a specific decision when they need to? People can lack capacity to make some decisions, but have capacity to make others. Mental capacity can also fluctuate with time – someone may lack capacity at one point in time, but may be able to make the same decision at a later point in time.

Question 12

Deputies appointed by the Court of Protection

Answer 12

manage the affairs of someone who lacks the mental capacity to manage their own affairs

Question 13

Advance Decisions to refuse treatment

Answer 13

advance decision to refuse treatment lets you, while you have mental capacity, choose and explain which medical treatments you do not want doctors to give you, if a time comes when you lack capacity and cannot make the decision or communicate your wishes.

Question 14

Independent Mental Capacity Advocate (IMCA)

Answer 14

MCAs are a legal safeguard for people who lack the capacity to make specific important decisions: including making decisions about where they live and about serious medical treatment options. IMCAs are mainly instructed to represent people where there is no one independent of services, such as a family member or friend, who is able to represent the person.

Question 15

Independent Mental Health Advocate (IMHA)

Answer 15

IMHAs are independent of mental health services and can help people get their opinions heard and make sure they know their rights under the law.

Question 16

section 2 of MHA

Answer 16

upto 28 days

Question 17

section 3 of MHA

Answer 17

upto 6 months

Question 18

community treatment disorder

Answer 18

A Community Treatment Order allows a person who has been Detained in hospital for treatment to leave hospital (discharged from detention) and get treatment in the community.

A CTO is an order made by your responsible clinician to give you supervised treatment in the community.
This means you can be treated in the community for your mental health problem, instead of staying in hospital. But your responsible clinician can return you to hospital and give you immediate treatment if necessary.

Question 19

section 5(4) of MHA

Answer 19

gives nurses the ability to detain someone in hospital for up to 6 hours.

Question 20

section 5(2) of MHA

Answer 20

gives doctors the ability to detain someone in hospital for up to 72 hours

Question 21

section 136

Answer 21

The police can keep you at the place of safety for up to 24 hours, which can be extended for another 12 hours if it was not possible to assess you in that time. The time starts when you arrive at the place of safety, or whenever the police arrived if you are not taken somewhere else.

Question 22

section 135

Answer 22

Section 135 allows the police to enter your home and take you to (or keep you at) a place of safety so that a mental health assessment can be done. This could involve keeping you at home.

Question 23

section 117

Answer 23

It obliges councils and the NHS to provide aftercare services, including a care home place if that is needed, for people who have been discharged from hospital having been detained for treatment under the Mental Health Act 1983