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Mental Capacity Act 2005

Mental Capacity Act 2005

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Mental Capacity Act 2005

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  1. Mental Capacity Act 2005 Jill.Manthorpe@kcl.ac.uk evidem july 08 summer sch mca

  2. Great expectations Alzheimer’s Society: ‘The law marks a major turning point in the legal rights of people with dementia and their carers….The Society has long been campaigning for these rights which mark a major milestone for people with dementia’. Share, Alzheimer's Society, March 2007. pp12-13 evidem july 08 summer sch mca

  3. asking the experts evidem july 08 summer sch mca

  4. A daughter's experience – June 2008 • It wasn’t too bad • Got the LPA form off the web – waiting to register but there’s a backlog • Expect that we will have problem with dad’s GP ‘who can’t move without consulting his Mimm’s’ evidem july 08 summer sch mca

  5. Person with dementiaJune 2008 • I’ve revoked my EPA and made a LPA • I had made an advance directive before MCA, haven't changed as it is fit for purpose • Put in items about my wishes, eg no bath but showers (haven’t had a bath for years) • Lodged with bank as I think my solicitor is useless evidem july 08 summer sch mca

  6. Practice perspectives • Information • Communication • Assessment • Planning • Intervention • Monitoring and Review evidem july 08 summer sch mca

  7. (1) Information giving • Timing • Duplication • Gaps • Links in the chain • Information set evidem july 08 summer sch mca

  8. Information example: - when should staff in a memory clinic tell a person attending with suspected dementia about the MCA? • When breaking the news of the diagnosis? • Afterwards? • Before? • What if the person does not want to know? • What to record in the files? • Which other professionals to tell? evidem july 08 summer sch mca

  9. (2) Communication What is the best way of telling people about their rights, to make decisions and making arrangements? • We and they know a lot already • We know that some plan and some don’t • We know that leaflets have their limits • We know the value of personalised and relevant approaches‘people like me’ evidem july 08 summer sch mca

  10. (3) Assessment • How are assessment documents in health and social care recording MCA assessments and decisions? • What happening in self assessment? • Will the MCA help in investigating adult safeguarding concerns? . evidem july 08 summer sch mca

  11. Assessing Capacity • Does the person have general understanding of what the decision is and why they are being asked to make it? • Do they understand the consequences of making, or not making, the decision? • Are they able to understand the information relevant to the decision? • Can they weigh up the relative importance of the information? • Can they use the information as part of the decision making process? • Can they communicate their decision? Even with assistance… evidem july 08 summer sch mca

  12. (4) Planning Example: Mrs X has Alzheimer’s disease and lives with her sister. The house needs rewiring. It has been agreed that they should move temporarily but this upsetting. Her sister says she will say they are going for a walk…hide the keys… What might the care plan say? evidem july 08 summer sch mca

  13. (5) Intervention Mrs X is admitted to hospital with a broken ankle. How will the MCA support her rights? • In care and treatment? • Over discharge? • In making choices? • To dignity? evidem july 08 summer sch mca

  14. (6) Monitoring • Thinking about wishes – relevance of MCA for those who have not LPA or advance decisions • Being aware of the LPA and advance decisions • Recalling the new offences of mistreatment and wilful neglect • Thinking about Deprivation of Liberty safeguards (Bournewood) – see Code of Practice evidem july 08 summer sch mca

  15. Is the MCA changing practice? Every thing is clear? Everyone has made their plans It is all straightforward? No one changes their minds, or has family who disagree Plans are there when needed? In the hand bag Records are easy to find and comprehensive? Shared evidem july 08 summer sch mca

  16. Information • Code of Practice • CSIP activities • DH training sets (on line, CD and paper) • Ministry of Justice publications • Imminent Deprivation of Liberty Safeguards (Code of Practice) evidem july 08 summer sch mca