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Least restrictive practice: What does the Mental Capacity Act say?

If someone were to say “we can’t go out there at the moment, shall we have a cuppa we wait” or  “sorry, it’s dark outside so garden’s not open until to 8am”, be provided with a medication to sedate or calm as a medical restraint such as promethazine or lorazepam, be secluded to a certain area to keep their dignity if undressed or be restrained in their best interest once all other alternatives have been trialled repeatedly, these are all forms of restrictive practices and restraint. No matter how cooperative or accepting of the support provided. They are different forms, different levels, but all restrictive, affecting a person’s freedom of movement and choice through limiting access, provision of sedative medication, seclusion or restraint.

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Mental Capacity: Elderly lady watching video supported by nurse in mask.

Accessibility in a digital age

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Equal access for all has been a standing call for social inclusion and disability rights activists for many years. Ramps have been custom built for venues, alternate access routes established, consideration of visual distinguishment on steps for those who are visually impaired added, contrast colours established on posts and lifts put in amongst many other elements to ensure everyone can physically move as freely as possible.

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Lady in wheelchair facing away from camera, looking down a paved street

How to explain assessments to people who are being assessed

We all have a large amount of underlying assumptions or associations in all elements of our lives, which we are encouraged as working professionals to stop and reflect on in order to reduce the impact of these on our daily practices. Without this professional conduct we risk being biased, unprofessional, incur misunderstandings or cause offence. Whether it is surrounding age, gender, health conditions, political outlook, faith, religion, education or appearance.

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Elderly lady walking outside arm in arm with nurse. Photo by Cristina Serí on Unsplash.

Mental Capacity Assessments: Where to start?

From talking to colleagues, team members from different settings and other professionals across the board about the topic of the Mental Capacity Act and its Assessment, one of the most common stumbling blocks reported appears to be – where to start with an assessment, closely followed by the contents of completed assessments. It can leave some people feeling really overwhelmed and unsure of themselves, while others are thriving at the challenge, identifying ways to establish a “standard” for their own working environment. 

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Elderly gentleman and young man in red hat smiling and enjoying time together. Photo by Nathan Anderson on Unsplash.

Why are Mental Capacity Assessments so important?

Reflecting back upon my experiences to date, it is noteworthy that when I first started working in health care there was very little said about capacity yet there was a lot of emphasis said about consent, especially that of informed consent. Consent to treatment, consent to an intervention, consent to support with personal care, consent to speak to a family member, consent to take photos, consent to store information or share with the GP. The list is quite endless and is a staple of not just the health care system, but our society as a whole that has grown in importance over the years.

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