Special Care Summary

Question 1

What is a POA?

Answer 1

Granted while capacity
Provide support with financial/property/medical

Question 2

What are the different types of POAs? (3)

Answer 2

Continuing - financial+property
Welfare - health+personal
Combined - most common

Question 3

What is a guardianship order?

Answer 3

Court appointed for those who never had capacity

Question 4

Demonstrating capacity principles

Answer 4

Understand tx
Understand purpose of tx
Consequence of no tx
Risks/benefits/alternatives
Retains memory + communicates back

Question 5

Define the AWI Act 2000

Answer 5

A framework for safeguarding the welfare/finances of adults who lack capacity due to mental illness/learning disability

Question 6

Principles of the AWI Act

Answer 6

Benefit to pt
Least restrictive option
Consult with relevant others
Encourage pt to use existing skills

Question 7

Who can consent for tx?

Answer 7

POA/ Welfare guardian
GMP/GDP under section 47 AWI

Question 8

Principles of consent (6)

Answer 8

Valid
With capacity
Informed
Voluntary
Not coerced
Not manipulated

Question 9

General authority to tx pts with concerns

Answer 9

NON EMERGENCY TX:
AWI Valid certificate of incapacity

EMERGENCY TX:
Manage pain in least invasive way + document well
Arrange follow up to complete further tx post paperwork

Question 10

OSCE station protocol

Answer 10

• Discuss procedure + gauge capacity by asking pt to repeat
• Enquire if GMP aware, if pt has POA/welfare guardian/relative appointed (express concern)
• DWP: importance of capacity to consent for tx
• Reluctant to tx pt may avoid
  Importance of emergency tx today in least invasive way
• Review - once relevant paperwork obtained can formulate tx plan + proceed with non emergency tx