Mental Capacity can be impacted by an impairment or disturbance of the brain that directly affects cognitive functioning. In today’s blog we look at a selection of short-term and long-term conditions that can be a direct factor.
In everyday healthcare practice we are directed by legislation and best practice guidance to gain informed consent for medical interventions, care plans and, broadly speaking, any professional interaction. This includes consent to be photographed, which in years gone by would have included use on medication charts (MARS sheets), care plans and care provider notice boards. In more recent years, it also includes the use of photos shared on social media, email and messaging services such as WhatsApp.
If someone is unable to demonstrate mental capacity to assign a Lasting Power of Attorney (LPA), and is unable to manage either their health and welfare or property and financial affairs, then an application can be made to the Court of Protection (COP) to assign a deputy to said role if appropriate.
In simple terms a deprivation can be described as a restriction, while a deprivation of liberty is a restriction on everyday living. The Mental Capacity Act enacts vital safeguards and protections an individual who can not consent to their care and treatment is is deprived of said liberties. It protects the individual through upholding their rights, monitoring any form of restriction in place and striving to ensure these are proportionate, justifiable and the least restrictive option. In today’s blog, we consider what these restrictions may include, and the importance of keeping the individual’s voice at the heart of any Best Interest decision.
There have been a number of high-profile Court of Protection (CoP) cases this year on the subject of DoLS placement and provisions. These cases each raise questions around the least restrictive option for the individual, what classes as ‘best interest’, and what do we mean by proportionate, reasonable and justifiable care.
There are occasions where an individual may be unwilling or unable to engage with a mental capacity assessment, from which there are many possible reasons why this may occur. For example, there may be an issue with the specific context of the situation, the individual’s health conditions, the professional’s approach to the test, or even the adaptations that have been made to support.
There are often many complex interactions between legislation and case law – especially in the field of mental capacity and the Mental Capacity Act (2005) specifically. For this reason it is vital for professionals working in this area to ensure they are familiar with updates in case law to ensure those within the system are protected and best practice is upheld.
Over many years of professional practice I have come across a number cases where certain vulnerable individuals have found themselves unable to make a decision, most frequently when they are confronted with a ‘big decision’ of lasting consequence.
While in some cases it can be sensible to put off a decision until more information becomes available, this ‘decision paralysis’ can sometimes have lasting and quite damaging consequences. This is especially true where decision paralysis can lead to delays in treatment or reduce the quality of life of the individual while they mull over their decision.
Anyone can conduct a Mental Capacity Assessment. However, context is important, and a professional may be required for complex decisions. This will help ensure assessments are carried out in the correct manner, and that they are valid (i.e. reliable and trustworthy) in order to protect both the assessor, and the person being assessed.
There are several terms that are used to describe the process of determining a person’s mental capacity. Is it a Mental Capacity Test, or a Mental Capacity Assessment? In this blog, we explore some of the language around the Mental Capacity Act (2005) and how it applies in practice.