Search results for ‘Subject term:"mental capacity"’ Sort:
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The Mental Capacity Act requirements for clinical decisions regarding treatment and care
- Authors:
- GRIMSHAW Karen, LYNE Michael, BROWN Keith
- Publisher:
- National Centre for Post-Qualifying Social Work and Professional Practice
- Publication year:
- 2020
- Pagination:
- 8
- Place of publication:
- Bournemouth
This document is part of a series of brief guides to help all health and social care professionals navigate through and apply the principles of the Mental Capacity Act for decisions regarding treatment and care. The guide focuses specifically on the Act requirements for clinical decisions, covering: consent to treatment and care; factors affecting mental capacity to consent to treatment and care; who assesses capacity to consent to treatment and care; checklist for practitioners assessing mental capacity; clinical decisions where the individual lacks capacity to consent to treatment or care. (Edited publisher abstract)
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.
The capacity to give informed consent in a homeless population with developmental disabilities
- Authors:
- MORTON Larry G., CUNNINGHAM-WILLIAMS Renee M.
- Journal article citation:
- Community Mental Health Journal, 45(5), October 2009, pp.341-348.
- Publisher:
- Springer
This study examined homeless persons with developmental disabilities and their ability to understand the informed consent process for research using a capacity-to-consent screener. Bivariate associations with the inability to pass the screener on the first attempt were noted with three factors: an eighth grade or less in education, chronic homelessness, and mental retardation diagnosis. With multiple regression, the only outcome associated with inability to pass the screener on the first attempt was an eighth grade or less education. This study indicates the need for consideration of developmental disabilities when homeless and mental health providers are working with the homeless community.
Advance care planning
- Authors:
- GRIMSHAW Karen, BROWN Keith, LYNE Michael
- Publisher:
- National Centre for Post-Qualifying Social Work and Professional Practice
- Publication year:
- 2020
- Pagination:
- 8
- Place of publication:
- Bournemouth
This guide is part of a series of brief guides to help all health and social care professionals navigate through and apply the principles of the Mental Capacity Act for decisions regarding treatment and care. The guide looks at Advance Care Planning (ACP) as a way in which individuals can discuss and make clear their wishes and choices for treatment and care, which may become relevant at a future time, when they lack capacity to make decisions for themselves. It outlines the process of Advance Care Planning and discusses its implications in relation to: person-centred care; informing best interest decisions; refusal of medical treatments; and decisions about emergency care. Supporting and encouraging individuals to look forward and consider the treatment and care they may require in the future is an increasingly important aspect of clinical care – in health and social care settings. Whether the person is in an acute hospital, community hospital/unit, care home or receiving care in their own home, practitioners need to be mindful of decisions individuals may need to make, or have made, regarding future care – for urgent treatments, such as resuscitation, acute treatments or priorities for end-of-life care. (Edited publisher abstract)
Money and valuables and research code of practice [Draft]
- Author:
- NORTHERN IRELAND. Department of Health
- Publisher:
- Northern Ireland. Department of Health
- Publication year:
- 2019
- Pagination:
- 12
- Place of publication:
- Belfast
This Code of practice provides an overview of the relevant provisions of the Mental Capacity Act (Northern Ireland) 2016 Act, to help those working with care home residents or in-patients who lack, or may lack, capacity in relation to their money, valuables and financial affairs. It also sets out what research can be carried out and what procedures needs to be followed when carrying out research with someone who lacks capacity to consent. The Code should be read in conjunction with the 'Deprivation of Liberty Safeguards: code of practice', 2019. (Edited publisher abstract)
Uncertainties when applying the Mental Capacity Act in dementia research: a call for researcher experiences
- Authors:
- FLETCHER James Rupert, LEE Kellyn, SNOWDEN Suzanne
- Journal article citation:
- Ethics and Social Welfare, 13(2), 2019, pp.183-197.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
The Mental Capacity Act (MCA) has been in force in England and Wales for over a decade. Although often considered in relation to health and social care, the MCA also governs the inclusion of people with cognitive impairment in research. This includes procedures for establishing whether prospective participants are able to consent to participation. Despite its importance in research, there is little literature detailing accounts of researcher’s experiences of working with the MCA’s decision-making capacity procedures when conducting research. To address this deficit, the authors present their experiences of conducting three separate studies involving people with dementia and therefore falling within the MCA’s research provisions. Study A (data collected between September 2016 and April 2017) discusses the subjectivity of capacity assessment; Study B (data collected between July and November 2017) details the negotiation of different opinions on capacity; and Study C (data collected between January and October 2013) considers tensions between legality and the principle of non-maleficence. Each of these experiences indicates a problematic degree of uncertainty within the MCA’s decision-making capacity provisions. The authors suggest two solutions. First, more detailed guidance is required, responding to uncertainties emerging in practice. Second, researchers should be encouraged to publish their experiences of working with the MCA. (Edited publisher abstract)
A pragmatist's guide to the assessment of decision-making capacity
- Authors:
- ZHONG Rocksheng, SISTI Dominic A., KARLAWISH Jason H. T.
- Journal article citation:
- British Journal of Psychiatry, 214(4), 2019, pp.183-185.
- Publisher:
- Cambridge University Press
Choice, understanding, appreciation and reasoning compose the standard model of decision-making capacity. Difficulties in determining capacity can arise when patients exhibit partial impairment. The authors suggest that a pragmatic approach, focusing on how capacity status affects the ultimate decision to override the patient's wishes, can help evaluators resolve difficult cases. (Edited publisher abstract)
Addressing challenges in gaining informed consent for a research study investigating falls in people with intellectual disability
- Authors:
- HO Portia, et al
- Journal article citation:
- British Journal of Learning Disabilities, 46(2), 2018, pp.92-100.
- Publisher:
- Wiley
Background: People with intellectual disability encounter substantial healthcare discrepancies, yet are under‐represented in research. While people with intellectual disability can make valuable contributions to research and consequently improve their quality of life, researchers encounter multiple challenges including them in research. One challenge is to support them in making an informed decision to participate in research. Therefore, the aim of this study was to describe and reflect on a consent procedure used while gaining informed consent, when recruiting potential participants into an ongoing study. Methods: A systematic and holistic consent procedure, underpinned by ethical guidelines, was developed and used alongside recommended strategies to engage people with intellectual disability in a research study. Results: Only three participants (7.5%) were deemed capable of consenting independently, while 37 participants (92.5%) required the support of a proxy. Of these 37 participants, 22 participated in the consent process, while 15 depended mainly on their caregiver to make decisions for them. Adapted communication strategies were found to facilitate a person who has an intellectual disability's participation in the consent procedure. The adapted written information sheets were of secondary importance. Conclusion: The consent procedure was a respectful means of determining a person's capacity to consent and indicating where there was a need for proxy consent. Appropriate communication strategies and the inclusion of familiar caregiver(s) were critical components for facilitating the person with an intellectual disability to participate in the consent procedure. (Edited publisher abstract)
Intellectual disabilities and decision making at end of life: a literature review
- Authors:
- KIRKENDALL Abbie, LINTON Kristen, FARRIS Saritha
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 30(6), 2017, pp.982-994.
- Publisher:
- Wiley
Background: Individuals with an intellectual disability are vulnerable to having end-of-life decisions made for them merely due to the presence of a disability. As a result, decisions made by others may not reflect the exact wishes of the individual. Methods: This review examines literature on individuals with an intellectual disability in making end-of-life decisions from the years 2000 to 2014. A total of 38 articles were found with 12 articles having a direct focus on end-of-life decision making. Results: The emerging themes include the following: (i) assumption of lack of capacity, (ii) inconsistency in evaluating capacity and communication challenges and (iii) third party decisions. Conclusions: Earlier discussions about end-of-life planning before the diagnosis of a life-limiting illness would be beneficial. Lacking is a consistent approach to determining capacity for individuals with an intellectual disability. The findings from this review provide a foundation for a decision tree in end-of-life decision making for individuals with an intellectual disability. (Edited publisher abstract)
Understanding sex: the right to legal capacity to consent to sex
- Author:
- ARSTEIN-KERSLAKE Anna
- Journal article citation:
- Disability and Society, 30(10), 2015, pp.1459-1473.
- Publisher:
- Taylor and Francis
This article addresses the right to legal capacity to consent to sex of people with intellectual disabilities. Article 12 of the Convention on the Rights of Persons with Disabilities guarantees the right to legal capacity on an equal basis in all areas of life. This article discusses sex as an area of life in which people with intellectual disabilities are frequently not being granted legal capacity on an equal basis. The article examines current capacity to consent to sex law in Ireland, England and Wales in light of Article 12. It proposes an ‘agreement model’ as a potential alternative that would be Article 12 compliant. (Publisher abstract)