dementia and the mental capacity act - elderly care conference 2015, sam cox
TRANSCRIPT
Decision-making survey
• 119 paper responses from people with dementia
• 87 online responses from people with dementia
• 197 paper responses from carer’s of people with dementia
• 472 online responses from carer’s of people with dementia
People living with dementia:
• Only 15% of people living dementia were aware of the MCA?
• Almost 1 in 5 people with dementia surveyed felt that either all, or most of the time, decisions were made for them without them being asked
• Only 12% of people with dementia felt that professionals always supported them to make decisions
• But 28% said that professionals never, or rarely did this
• Only 23% of people with dementia felt that they could challenge professionals who did not use the MCA correctly
Carer’s
• Only 52% of carer’s had heard of the MCA
• Only 1 in 4 carers knew that they could judge capacity for everyday decisions
• 44% of carers were unaware that they had a right to be consulted in decisions
• Only 27% of carers that were attorneys felt that that their decisions were respected all of the time
• Only 43% of carers felt that they could challenge a professional who did not use the MCA correctly
Brian
• He feels he has lost control of his life, that things he use to decide are now being decided for him
• It has been decided that he won’t go on holiday this year
• It has been decided that he should no longer go out for walks on his own
• On some days he feels that every decision he use to make is being made for him
MCA
• Assumption of capacity
• Supportive decision making
• Unwise decisions
• Best interest decisions
• Least restrictive
• MCA principles
• MCA does provide guidance for carer’s
• Carer’s within the decision-making survey commented on how the MCA is guidance for them
Sarah v George
• Both care for their mum, but have very different ideas about what they think is best
• Sarah wants mum to move in with her, whilst George thinks she needs the care a care home can provide
• Don’t see how this can move forward
• Both attorney’s for LPA P&FA but no LPA for H&W
The MCA can apply here
• Whose decision is it?
– Assumption of capacity – so mum
– Involving a professional, e.g. social worker
• The MCA can be used to outline how to make this decision
– Best interests
– Least restrictive
Shelly
• Joint bank account has been frozen
• No LPA has been made – was told that as they had a joint bank account they would not need one
MCA
• Ideally – she would have been given the correct information
• Deputyship – are problems with this though
Tom
• Mum’s moving into a care home
• Doesn’t agree with the decision
• Was told that he didn’t need a LPA for health and welfare and now they won’t let him make these decisions and won’t talk to him
MCA
• Ideally would have had the LPA for H&W
• However, the professional MUST follow the MCA in making this decision
– Must consult Tom
– Consider his mum’s wishes
– Least restrictive
Amy
• End of life care – she believes that her mum’s treatment should be withdrawn
• Her mum always said she never wanted this sort of treatment
• Doctors are still providing treatment
• No LPA, and they won’t discuss the matter with her
MCA
• Ideally – her mum would have made an advance decision
• Or – she would have an LPA for H&W
• Yet – under the MCA, BI decisions she should still be consulted
Therefore:
• The MCA is something that can effect most aspects of a person with dementia’s life
• Provides rights for people with dementia
• Enables someone to plan ahead
• Provides guidance for carer’s
• Provides rights for carer’s and families
The MCA is not just important to professionals but to everyone…
Film