Search results for ‘Subject term:"mental capacity"’ Sort:
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Improving recording of capacity to consent and explanation of medication side effects in a psychiatric service for people with learning disability: audit findings
- Authors:
- ROY Ashwin, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 15(2), June 2011, pp.85-92.
- Publisher:
- Sage
- Place of publication:
- London
This study investigated the practice of six psychiatrists in a large English inner city learning disability service in recording capacity to consent to treatment and possible side effect dialogue. It also examined the impact of measures aimed at improving this process. Audits were completed in 2007, 2008 and 2009, each one examining 26 randomly selected case notes, and data were collected on recording of capacity and documentation of an explanation of the potential side effects. Changes in practice following the introduction of a rubber stamp in 2008, designed as a visual prompt for clinicians, were also investigated. Findings revealed that the likelihood of recording of capacity rose from 30% in 2007 to 51% in 2009. Capacity was more likely to have been recorded if the stamp was present. Recording of side effect discussion was consistently higher than that of capacity and showed little change between cycles – remaining over 70%. The authors concluded that the introduction a rubber stamp in case notes was associated with improvements in the recording of capacity assessments.
People with learning disabilities who have cancer: an ethnographic study
- Authors:
- TUFFREY-WIJNE Irene, et al
- Journal article citation:
- British Journal of General Practice, 59(564), July 2009, pp.503-509.
- Publisher:
- Royal College of General Practitioners
Cancer incidence among people with learning disabilities is rising. This study aimed to provide insight into the experiences and needs of people with learning disabilities who have cancer. A prospective qualitative study was carried out using ethnographic methods. The participants were 13 people with learning disabilities ranging from mild to severe, who had a cancer diagnosis. The main method of data collection was participant observation (over 250 hours). The median length of participation was 7 months. Participants' cancer experiences were shaped by their previous experience of life, which included deprivation, loneliness, and a lack of autonomy and power. They depended on others to negotiate contact with the outside world, including the healthcare system. This could lead to delayed cancer diagnosis and a lack of treatment options being offered. Most participants were not helped to understand their illness and its implications. Doctors did not make an assessment of capacity, but relied on carers' opinions. The authors conclude that urgent action is warranted by findings of late diagnosis, possible discrimination around treatment options, and lack of patient involvement and assessment of capacity in decision making. There are significant gaps in knowledge and training among most health professionals, leading to disengaged services that are unaware of the physical, emotional, and practical needs of people with learning disabilities, and their carers.
Minimising the use of restraint in care homes for older people: making decisions
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2010
- Place of publication:
- London
In this film, three experts – an occupational therapist, a care home adviser who is a co-author of a report on restraint and a geriatrician discuss the complex issue of restraint in care homes. Each expert discusses a different aspect of restraint, considering how care home staff can balance the duty to care with the need to protect residents. To minimise the use of restraint and to help residents live the life they want to achieve, care home staff need to find out about the individuals in their care. Through dialogue and negotiation, they can help residents to exercise choice. The Mental Capacity Act provides a useful framework for decision making and this is explained in full. Note: This film is no longer available to view.
Brief guide to the Mental Capacity Act 2005: implications for people with learning disabilities
- Authors:
- HARDIE Elaine, BROOKS Liz
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2009
- Pagination:
- 43
- Place of publication:
- Kidderminster
This guide is for those who work with people who have a learning disability and will also be of use to parents and carers, friends and advocates. It aims to: explain the key points of the Mental Capacity Act 2005; explain what some of the choices and decisions might be; help carers support someone with a learning disability to plan ahead and talk about their future. Case studies are used to demonstrate key points of the act and how it might be applied in real life situations. (Edited publisher abstract)
The relationship between cognitive function and performance in instrumental activities of daily living in older adults
- Authors:
- TOTH Cheryl, et al
- Journal article citation:
- British Journal of Occupational Therapy, 85(2), 2022,
- Publisher:
- Sage
Introduction: Deficits in cognition have been found to be associated with problems in performing daily activities; however, it is unknown what specific domains of cognition are related to each daily activity. Method: Thirty-six occupational therapists identified the 20 most important instrumental activities of daily living for older adults and the cognitive demands required. Thirty-two older adults rated the perceived mental effort when performing these activities. They were assessed on their cognitive functions. Descriptive statistics were used to report the results. The Pearson correlation coefficient was used to identify relationships between cognitive functions and perceived mental effort. Results: Activities relating to 'communication', 'financial management', 'health management' and 'safety and emergency management' require more cognitive demands. Results from the older adults showed the highest significant correlations in immediate memory and 'paying bills' (r = 0.54), delayed memory and 'following emergency procedures' and 'paying bills' (rs = 0.52), and executive functioning and 'making and keeping medical appointments' (r = -0.49). Conclusion: Findings contribute to the emerging understanding of specific cognitive domains related to the instrumental activities of daily living. The results can be used to reframe and improve intervention strategies for individuals with cognitive decline to maintain or improve performance in daily activities. (Edited publisher abstract)
Overcoming challenges in the Mental Capacity Act 2005: practical guidance for working with complex issues
- Authors:
- Kong Camillia, KEENE Alex Ruck
- Publisher:
- Jessica Kingsley
- Publication year:
- 2018
- Pagination:
- 176
- Place of publication:
- London
This book provides mental capacity practitioners with accessible ethical guidance and applicable tools for applying the Mental Capacity Act (MCA) 2005. It shows how clients' relationships can impact their capacity in positive and negative ways, and which communication skills practitioners can use to enable and empower those with impairment. It also covers how to engage in self-reflection and transparent debate about values to improve the quality of assessments. (Edited publisher abstract)
Getting it right in time: parents who lack litigation capacity in care proceedings
- Authors:
- WELBOURNE Penelope, MacDONALD Paula, BATES Philip
- Publishers:
- Nuffield Foundation, Plymouth University
- Publication year:
- 2017
- Pagination:
- 96
- Place of publication:
- London
This study looks at the characteristics of parents lacking litigation capacity in care proceedings and identifies key aspects of provision that could help them to get fair representation in court and participate in hearings. The study examined how many parents are found to lack litigation in care proceedings, their key characteristics - such as age, gender, the issues that led to them lacking litigation capacity, and the number of children involved in proceedings where a parent lacks litigation capacity. It also explores the courts and Office of the Official Solicitor respond to the Public Sector Equality Duty under the Equality Act 2010 in cases involving parents who lack litigation capacity. The study found that lack of litigation capacity may be due to mental health problems, intellectual disability, or a combination of factors. Capacity is also issue specific, so some people may have capacity to make some decisions, but not others. It can also fluctuate, especially in the case of a mental health problem. It also found that very few parents ended proceedings with the care of their children. Based on the findings, the report makes recommendations to support parents who lack litigation capacity. These include: for courts to provide the technology and space to enable parents who have specialist communication and participation needs to observe, understand and participate in hearings; and in cases that require an interpreter the support of an intermediary to help any interpreter communicate with a parent who lacks litigation capacity. (Edited publisher abstract)
A voice of their own: a toolbox of ideas and information for non-instructed advocacy
- Author:
- LAWTON Annie
- Publisher:
- British Institute of Learning Disabilities
- Publication year:
- 2014
- Place of publication:
- Birmingham
- Edition:
- 2nd ed.
This toolbox is designed to support advocacy for people with barriers to communication and high support needs. It examines why it is difficult for some people to get advocacy support and make their voices heard, what skills are needed to find out what people want to say and how to ensure people are not only heard but also taken seriously. It contains information sheets including different tools, practical ideas and suggestions. Giving a range of examples of different ways that advocates have supported their advocacy partners, it argues that there is no one right way to do this and that advocates should rather look for ways that works for the individual they are supporting. (Edited publisher abstract)
Capacity to communicate: Sense’s three-year project training independent mental capacity advocates in communication skills
- Author:
- LEE-FOSTER Angela
- Journal article citation:
- Journal of Adult Protection, 12(1), February 2010, pp.32-42.
- Publisher:
- Emerald
Sense, the national charity that supports and campaigns for children and adults who are deafblind, set up the Capacity to Communicate Project in response to the new role of independent mental capacity advocates created by the Mental Capacity Act 2005. The project has three main aims: to provide training for independent mental capacity advocates (IMCAs) and other advocates on the process and practice of good communication with those who have little or no formal communication, including deafblind people; to provide information for families on advocacy entitlements and benefits; and to provide information for local authorities outlining the value of advocacy for those lacking capacity. As part of the training, advocates were asked to submit a written assignment. This article outlines the project and gives illustrative case studies. The author comments that these case studies, including some adult protection cases, have provided valuable information about the nature and process of independent mental capacity advocacy and what can be done to improve this relatively new statutory role, in particular developing better understanding, skills and processes around communication in order to represent and protect vulnerable adults.
Making safeguarding personal and social work practice with older adults: findings from local-authority survey data in England
- Authors:
- COOPER Adi, COCKER Christine, BRIGGS Mike
- Journal article citation:
- British Journal of Social Work, 48(4), 2018, p.1014–1032.
- Publisher:
- Oxford University Press
This article presents the results of a survey of English local authorities undertaken in 2016 about the implementation of Making Safeguarding Personal (MSP) in adult social care services. MSP is an approach to adult safeguarding practice that prioritises the needs and outcomes identified by the person being supported. The key findings from a survey of local authorities are described, emphasising issues for safeguarding older adults, who are the largest group of people who experience adult safeguarding enquiries. The survey showed that social workers are enthusiastic about MSP and suggests that this approach results in a more efficient use of resources. However, implementation and culture change are affected by different factors, including: austerity; local authority systems and structures; the support of leaders, managers and partners in implementing MSP; service capacity; and input to develop skills and knowledge in local authorities and partner organisations. There are specific challenges for social workers in using MSP with older adults, particularly regarding mental capacity issues for service users, communication skills with older people, family and carers, and the need to combat ageism in service delivery. Organisational blocks affecting local authorities developing this ‘risk enabling’ approach to adult safeguarding are discussed. (Edited publisher abstract)