To keep in mind Flashcards
When a social worker helps clients understand their options, offers informed perspectives, and supports them in making choices that align with their goals, the SW is practicing what?
Self-determination
Representation agreement (section 7) allows an individual to name another person to make or help them make …what and IF they…?
personal, health care, legal, and routine financial needs if they have difficulties understanding information OR in the event that they CANNOT make the decision (i.e. injury)
Powers of Attorney allow an individual to name another person to manage…what?
to manage ALL or SOME of their finances and property ONLY
With a general power of attorney, the attorney can manage your finances and property on your behalf …
ONLY while you are mentally capable of managing your own affairs.
What PoA ends when the person becomes mentally incompetent and can no longer make decisions
a general power of attorney
For either type of power of attorney to be made, the maker must be what?
be mentally/cognitively capable to understand
able to understand and appreciate financial and legal decisions and understand the consequences of making these decisions.
What is the difference between an enduring power of attorney and a general power of attorney?
the enduring power of attorney continues even if the person becomes mentally incompetent
When can the general power of attorney take effect?
When you sign it or at a specific date that you write in the document
When can the enduring power of attorney take effect?
when you sign it (when the maker is still capable) OR it can come into effect when the maker becomes mentally incapable.
Can someone still make decisions if they grant someone a power of attorney?
yes, so long as they are mentally capable
An enhanced (section 9) representation agreement can be made by an adult who…?
who can understand what the agreement is about, and what it allows their representative to do.
They need to be capable.
When thinking about a Representation Agreement, a representative is just one type of what? AND is part of what process?
substitute decision maker in BC law
part of “advance care planning”
In terms of making an enhanced (section 9) representation agreement, a person is considered capable unless…?
unless there is reason to think otherwise.
What representation agreement gives more power to make decisions i.e. *** care facility admission or can refuse consent to life-supporting treatment?
Enhanced (section 9)
A standard (section 7) representation agreement can be made by an adult even…?
even if they have SOME trouble understanding information
The adult can use WHAT agreement to name a representative to make or help them make health-care, personal-care, legal, and routine financial decisions if they have difficulties understanding information OR in the event that they CANNOT make the decision
Standard (section 7)
Representation agreement (section 9) allows an individual to name another person to manage…what?
personal and health care. Not financial or legal affairs.
When can a Representation Agreement be active or come into play?
as soon as you and your representative sign it unless you specify when it is to take effect
An advance directive is a written instruction that WHAT at a time when the health care is needed and you are not capable of giving or refusing consent to treatment
it gives or refuses consent to health care treatment
There is only one way to choose who your substitute decision maker is in BC, how?
– by appointing a Representative in a Representation Agreement.
In what circumstances is a temporary substitute decision maker (a person identified by your health-care provider from a list defined by laws) involved?
When you have no Representative Agreement or an Advance Directive.
Someone might make an advanced directive if?
You do not have anyone you want to name as a representative who can make health care decisions for you (i.e. no RA section 9 in place)
What two rights does every ADULT in BC have under the Health Care (Consent) and Care Facility (Admission) Act?
Accept or refuse health care
Take part in decision making about their own health care
Health care professionals must obtain WHAT from a patient before providing a health care treatment?
informed consent
Under BC legislation, a health care provider (who must obtain the client/patient’s informed consent) includes
social workers
If you are a heath professional responsible for obtaining consent for health care treatment, the Health Care (Consent) and Care Facility (Admission) Act requires you to follow these steps. PUT the steps in order:
If you are concerned the adult doesn’t understand the information provided about the health care and that this information applies to the adult’s situation, find out if there is a decision maker you can contact. They are, in order (see the PGT document)
If there is no representative or committee of person and no valid advance directive, you must choose the first willing, available and qualified temporary substitute decision maker from a list (i.e. spouse)
Ask the adult for a decision. An adult’s representative, family or close friend may support them to make this decision.
If there is no available, willing and qualified TSDM, or if there is a dispute between equally ranked TSDMs about who is to be chosen that cannot be resolved by the heath care provider, contact the PGT
1 - Ask the adult for a decision. An adult’s representative, family or close friend may support them to make this decision.
2 - If you are concerned the adult doesn’t understand the information provided about the health care and that this information applies to the adult’s situation, find out if there is a decision maker you can contact.
They are, in order –> A court-appointed committee of person THEN a representative appointed by the adult THEN a valid advanced directive.
3 - If there is no representative or committee of person and no valid advance directive, you must choose the first willing, available and qualified temporary substitute decision maker from a list (i.e. spouse)
4 - If there is no available, willing and qualified TSDM, or if there is a dispute between equally ranked TSDMs about who is to be chosen that cannot be resolved by the heath care provider, contact the PGT
As per HealthLink BC (Infants Act), a child under the age of 19 is called a WHAT?
a minor
As per HealthLink BC (Infants Act), “mature minor consent” is defined as the WHAT?
it is the consent a child gives to receive or refuse health care
A child who is a mature minor may make their own WHAT?
health care decisions independent of their parents’ or guardians’ wishes.
In B.C. there is no WHAT when a child is considered capable to give consent.
no set age
For a mature minor to provide consent for health care and make health care decisions, the health care provider must ensure the child understand what 3 things:
Hint: need, inv, ri/ben
- The NEED for the health care
- What the health care INVOLVES and
- The BENEFITS & RISKS of the health care
From the Health Care (Consent) and Care Facility (Admission) Act, for consent the health care provider gives the adult the information a reasonable person would require to understand the proposed health care and to make a decision, including information about:
(I) the ? for which the health care is proposed,
(ii) the ? of the proposed health care,
(iii) the ? of the proposed health care that a reasonable person would expect to be told about, and
(iv) ? courses of health care
condition
nature
risks and benefits
alternative
As a social worker, thinking about the 4 pieces that I need to discuss with a patient to ensure they can give informed consent, as per the Health Care (Consent) and Care Facility (Admission) Act, I would keep in mind what for each of the 4 below?
Use discharge as my example
Condition –>
Nature –>
Risks & Benefits –>
Alternatives –>
Condition –> Why is this needed or happening?
i.e. “You were admitted to the hospital due to… Now that your medical team feels you are stable, we need to plan your discharge to ensure you have the right supports in place”
Nature –> What does the process involve?
i.e. “We will discuss your current needs and preferences, explore available supports, and coordinate with services”
Risks & Benefits –> as it says
i.e. What are the positive and negative aspects of the discharge plan?
Alternatives –> what other options exist
i.e. What are the client’s choices?
You CAN make decisions in advance of become incapable, by setting up what 4 things?
- enduring power of attorney
- section 7 or 9 representative agreement
- advance directive
- A nomination for someone to become your committee (BUT this goes through court)
If you are mentally incapable of making decisions (AND nothing was put in place i.e. EPOA), trusted family or friends may be appointed WHAT for financial and legal matters and/or WHAT to look after personal and health care matters by a COURT ORDER.
committee of estate
committee of person
WHAT is it called when a senior lives in a way that puts his or her own health, safety, or well-being at risk?
Self-neglect
The Public Guardian and Trustee (PGT) may get involved as WHAT.
committee of estate
Public Guardian and Trustee (PGT) may be appointed as committee of estate by a certificate issued by a health authority.
A committeefor personal and health care matters can only be appointed by a court order.
If there is no willing or available temporary substitute decision maker (TSDM) then what happens 2 things can happen?
the Public Guardian and Trustee (PGT) can authorize someone to be the TSDM.
As a last resort, the PGT can act as TSDM.
When can the PGT can act as TSDM
As a last resort, when the adult has no legal substitute decision maker or advance directive, and no one is able or willing to be the TSDM (temporary substitute decision maker)
Even with a Representation Agreement signed and in place, if you are still capable then you can WHAT?
You can continue to make decisions until you are incapable of making those decisions.
When a POA is in place, examples of the attorney helping with financial affairs include…?
paying bills, doing your banking, paying your taxes
In BC, can a POA make medical, health or personal care decisions for the person?
No, such decisions are covered by representation agreements and advance directives
True or False - A child who is assessed by a health care provider as being capable to give consent is called a “mature minor”?
True
Under the Adult Guardianship Act (section 32) – as a social worker, if I have reason to believe that an adult may be incapable of managing their financial affairs, I must (2 things)?
request a qualified health care provider to assess the adult’s incapability
AND notify the Public Guardian and Trustee of the person’s belief
If an adult is mentally incapable of making decisions and there is no RA, EPOA, AD in place then a private committee comes into play.
What are the two types of private committees?
AND how does either committee come into play?
Committee of Estate (take care of an adult’s legal and financial affairs)
Committee of person (someone appointed to make decisions about health care / living arrangements).
either form of private committee must be appointed by the court
Under the Adult Guardianship Act (section 46) – as a social worker, if I have information indicating that an adult
is abused or neglected AND WHAT then I must do WHAT
If the adult is unable to seek support or assistance
I report to a designated agency ***See the decision tree
Citizens concerned about vulnerable adults who cannot manage their own financial, legal and personal care matters can contact who?
The Public Guardian and Trustee’s (PGT) who will complete an assessment and investigation
In terms of reporting possible adult abuse / neglect I have to think about whether the adult is able to seek assistance.
How can I determine this x3?
if an abused or neglected adult does not have a cognitive impairment affecting their ability to make decisions and/or can physically remove themselves from the situation, the adult is considered able to seek assistance on their own
If I believe a child or youth under 19 has been or is likely to be abused or neglected and WHAT?
Who do I report to?
AND the parent is unwilling or unable to protect the child or
youth
THEN I MUST report the suspected abuse or neglect to the Ministry of Children and Family Development
When thinking about suspected child abuse or neglect, “reason to believe” is based on what?
based on what you have seen or information you have received, you believe a child or youth has been or is likely to be at risk.
***You do not need to be certain.
In BC, Children between the ages of ? to ? years are called youth.
16 to under 19
In BC, physical abuse of a child includes what?
**A physical action i.e. slapping, shoving, shaking, burning
In BC emotional harm of a child is what 4 things?
» Anxiety;
» Depression;
» Withdrawal; or
» Self-destructive or aggressive behaviour.
In BC emotional ABUSE includes what 6 factors?
hint: sc, rej, verb, thre, ins, hum
» Scapegoating;
» Rejection;
» Verbal attacks on the child or youth;
» Threats;
» Insults; or
» Humiliation.
Examples of sexual abuse of a child include?
There are more than this:
» Sexual references (words or gestures) to the child’s or youth’s
body or behaviour
» Exposing the child or youth to sexual activity or material; or
» Sexual aspects of organized or ritual abuse.
When thinking about child neglect, it happens when a parent or guardian WHAT?
Ignores or overlooks a
child’s or youth’s basic needs – to the point where the child or youth
is, or could be, harmed.
examples of child neglect include failing to provide what 6 things?
Hint: f, s, bhc, s, n, p from r
food, shelter, basic health care, supervision, nurturing or
protection from risks.
Physical warning signs of child/youth abuse / neglect include what?
4 example points
injuries with no EXPLANATION
Poor clothing for the weather
looks unwell or hungry
poor personal hygiene
General warning signs of child/youth abuse / neglect include what?
running away from home
poor self-esteem (calling themselves bad)
problems at school
showing sexual knowledge not common for their age
having unexplained gifts
withdrawing from family/friends/activities
being secretive about “new” friends
If I need to report suspected child abuse or neglect, the steps when engaging with the child include the following put them in order:
Get only the facts (I don’t need a lot of details)
Tell the child/youth what will happen next (i.e. will be talking to a child welfare worker, who may need to talk to them, ***Don’t ever say I will keep it a secret)
Make the call right away, do NOT delay
Listen, be supportive.
1 - Listen, be supportive.
2 - Get only the facts (I don’t need a lot of details)
3 - Tell the child/youth what will happen next (i.e. will be talking to a child welfare worker, who may need to talk to them, ***Don’t ever say I will keep it a secret)
4 - Make the call right away, do NOT delay
True or False - As per the Ministry of Children and Family Development, with regards to suspected child abuse / neglet, if you are not sure, or if you have questions, or if you think
someone else has already made a report, or if you think a child
welfare worker is already involved, you should still call.
True
The Ministry of Children and Family Development’s Child and Youth Mental Health (CYMH) teams located across B.C. provide a range of mental health assessment and treatment options for children and youth (0-18 years of age) and their families at WHAT?
no cost!
True / False - Indigenous children and youth have an inherent right to remain connected to their parents, family, community, customs, traditions, language and territory. These rights are grounded in law.
TRUE
An Advanced Directive only addresses WHAT?
Health care ie to give or refuse consent to health care treatment
