older person mental health Flashcards
scales used to assess cognitive impairment
MOCA - montreal cognitive assessment
oxford cog screen
addenbrooke cognitive screen
what does a draw clock test for
executive function
what aspects are assessed in a cognitive assessment
attention memory fluency language visuospatial
what are the 5 core principles of MCA
Presumption of capacity
All practicable steps
Unwise decisions
Best Interests
Least restrictive
what is deprivation of liberty safeguard (DoLS)
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
how do you test if someone is being deprived of their liberty
acid test
Is the person subject to continuous supervision and control
Is the person free to leave
example of someone who is deprived of their liberty
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
what is diogenes syndrome
senile squalor
primary or secondary
primary cause of diogenes
personality abnormality and impact of ageing ,loss events and physical disability.
secondary causes of diogenes
presence of a mental disorder – Frontal Lobe , Depression ,OCD, Dementia
what is the two step capacity test for mental act
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.
Deputies appointed by the Court of Protection
manage the affairs of someone who lacks the mental capacity to manage their own affairs
Advance Decisions to refuse treatment
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.
Independent Mental Capacity Advocate (IMCA)
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.
Independent Mental Health Advocate (IMHA)
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.
section 2 of MHA
upto 28 days
section 3 of MHA
upto 6 months
community treatment disorder
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.
section 5(4) of MHA
gives nurses the ability to detain someone in hospital for up to 6 hours.
section 5(2) of MHA
gives doctors the ability to detain someone in hospital for up to 72 hours
section 136
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.
section 135
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.
section 117
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
