Capacity

​Understanding Capacity

Multiple Choice

What is the definition of capacity

• Ability to use, understand and communicate information to make decisions

• Ability to to understand complex medical information

• Refers to a persons overall cognitive function

• Ability to choose the recommended treatment

​- Name of Author

Capacity refers to the ability to use and understand information to make a decision and communicate any decision made

Multiple Choice

Which of one these would NOT impair someone's capacity?

• Intoxication of drugs or alcohol

• Dementia

• Sever learning difficulties

• Not being able to speak English

What can impair someone's capacity?

• Mental Health conditions - schizophrenia or bipolar disorder

• Dementia

• Severe learning disability 

• Brain damage - such as stroke or other brain injury

• Physical or mental conditions that cause confusion, drowsiness or loss of consciousness

• Intoxication caused by drugs or alcohol

Multiple Choice

Which of these is NOT in Part 2 of the capacity assessment?

• Ability to understand information about decision

• Ability to retain information about the decision

• Ability to communicate their decision

• Ability to make the medically best decision base on information

Multiple Choice

Which of these statements about capacity are true?

• Capacity applies to all decisions made in hospital

• In psychiatric patients it should be assumed they lack capacity

• Capacity can vary over time and decision

• Decision that are deemed unwise by doctors show lack of capacity

• Capacity is decision and time specific

• It should be assumed that a person has capacity unless reasons to believe otherwise

• Having a mental health conditions dose not mean someone will lack capacity - this is dependant on their current state (stable vs acute crisis)

• Everyone with capacity has the right to make a decision that is deemed unwise by medical professionals

Multiple Choice

Which of these is NOT included in the best decision checklist?

• Consider patient wishes and feelings

• Potential for future capacity

• Consider all relevant circumstances

• Prioritise best medical outcome for patient

Independent mental capacity advocate

The role of an IMCA is to:
`Gather information about the patient
Evaluate the information to ensure the persons wishes are being considered, multiple options have been explored and ensure the patient has received appropriate support.
Make representation , they should raise any issues and concerns with the decision maker. They are required to produce a report for the person who instructed them.
Challenge decisions either formally or informally

IMCA may be instructed if:
- The person is aged 16 or over

- A decision needs to be made about either a long-term change in accommodation or serious medical treatment

- The person lacks capacity to make that decision, and

- There is no one independent of services, such as a family member or friend, who is “appropriate to consult”

Multiple Choice

What best interest decisions should always be taken to Court of Protection?

• Sterilisation for contraception

• Withdrawal of nutrition/hydration from someone in a negative state

• Donation of organs or regenative tissue

• Invasive procedure in medical emergencies

Court of Protection

• If following the decision there is dispute or disagrement

• where a medical procedure or treatment is for the primary purpose of sterilisation

• in cases involving organ, bone marrow, or stem cell donation from a person who lacks capacity

• procedures for the covert insertion of a contraceptive device or other means of contraception

• where it is proposed that an experimental or innovative treatment be carried out;

• ny case involving a significant ethical dilemma in an untested or controversial area of medicine.

The Court of Protection makes a decision or appoints a decision maker on someone’s behalf in cases where there is no other way of resolving a matter affecting a person who lacks capacity. The following situations aways require review by the court of protection

Multiple Choice

What in Doreen's history would prompt a capacity assessment?

• Her age

• Residing in a nursing home

• Suspected malignancy

• Dementia

Multiple Select

Do you think Doreen lacks capacity to make a decision about the core biopsy?

• Yes

• No

What made you pick your answer, what else might you want to know?