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Difference between revisions of "Introduction to Consent and Capacity in Residential Care"
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Introduction to Consent and Capacity in Residential Care (view source)
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The Mini Mental Status Examination [“MMSE”] is one of the most commonly used tools used to assess capacity. Families members may be told a resident scored 22 out of 30 or 14 out of 30 on the “Mini Mental”, and consequently the person is mentally capable or is not mentally capable. This screening tool was never intended to be used as a diagnostic tool on its own, nor was it developed as an assessment of capacity.([[{{PAGENAME}}#References|19]]) | The Mini Mental Status Examination [“MMSE”] is one of the most commonly used tools used to assess capacity. Families members may be told a resident scored 22 out of 30 or 14 out of 30 on the “Mini Mental”, and consequently the person is mentally capable or is not mentally capable. This screening tool was never intended to be used as a diagnostic tool on its own, nor was it developed as an assessment of capacity.([[{{PAGENAME}}#References|19]]) | ||
There are four standards generally accepted in research and practice as required for evidence that someone is capable of decision-making: being able to understand information; being able to “appreciate”, i.e., applying information to their own circumstances and realizing the consequences for them; being able to reason how they came to a decision; and making a choice. Expressing a choice is seen as a lower threshold than reasoning, and being able to understand information is a less stringent test than appreciation. ([[{{PAGENAME}}#References|20]]) Yet these markers do not translate very well for the real life decisions in residential care, nor are they legal standards. | There are four standards generally accepted in research and practice as required for evidence that someone is capable of decision-making. These are: a) being able to understand information; b) being able to “appreciate”, i.e., applying information to their own circumstances and realizing the consequences for them; c) being able to reason how they came to a decision; and d) making a choice. Expressing a choice is seen as a lower threshold than reasoning, and being able to understand information is a less stringent test than appreciation. ([[{{PAGENAME}}#References|20]]) Yet these markers do not translate very well for the real life decisions in residential care, nor are they legal standards. | ||
==References== | ==References== | ||
#ACE (2004). Advocacy Centre for the Elderly. Long-Term Care Facilities in Ontario: The Advocate's Manual. Chapter 7 Decision Making , page 7.7 [“ACE: Decisionmaking”] | #ACE (2004). Advocacy Centre for the Elderly. Long-Term Care Facilities in Ontario: The Advocate's Manual. Chapter 7 Decision Making , page 7.7 [“ACE: Decisionmaking”] | ||
#Capacity to grant or revoke power of attorney. Online : http://whaleyestatelitigation.com/blog/2008/11/capacity-to-grant-or-revoke-power-of-attorney/ | #Goddard,J., Whaley, K.A., & Likwornik, H. Capacity to grant or revoke power of attorney. Online: http://whaleyestatelitigation.com/blog/2008/11/capacity-to-grant-or-revoke-power-of-attorney/ (Last accessed January 9, 2016) | ||
#ACE: Decisionmaking, p. 7.8 and 7.9. | #ACE: Decisionmaking, p. 7.8 and 7.9. | ||
#ACE: Decisionmaking. | #ACE: Decisionmaking. | ||
#Desormeaux v. Kicz (7 July 2000), Court File No. A-8757/2000 (Ontario Superior Court of Justice) at par.17. | #Desormeaux v. Kicz (7 July 2000), Court File No. A-8757/2000 (Ontario Superior Court of Justice) at par.17. | ||
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#Health Care (Consent) and Care Facility (Admission) Act [RSBC 1996] c. 181, s. 3. [“HCCCFA”]. | #Health Care (Consent) and Care Facility (Admission) Act [RSBC 1996] c. 181, s. 3. [“HCCCFA”]. | ||
#Power of Attorney Act [RSBC 1996] c. 370. | #Power of Attorney Act [RSBC 1996] c. 370. | ||
#BC Law Institute (2013). Report on Common Law Tests of Capacity, BCLI Report. No. 73. p. 13-16. Online: http://www.bcli.org/wordpress/wp-content/uploads/2013/09/2013-09-24_BCLI_Report_on_Common-Law_Tests_of_Capacity_FINAL.pdf (Last accessed: | #BC Law Institute (2013). Report on Common Law Tests of Capacity, BCLI Report. No. 73. p. 13-16. Online: http://www.bcli.org/wordpress/wp-content/uploads/2013/09/2013-09-24_BCLI_Report_on_Common-Law_Tests_of_Capacity_FINAL.pdf (Last accessed: January 9, 2016) [“BCLI Capacity”] | ||
#HCCCFA, s.3 (2). Also AGA, s. 3 (2) specifically notes “An adult's way of communicating with others is not grounds for deciding that he or she is incapable of making decisions about [the adult's personal care, health care and financial affairs]. | #HCCCFA, s.3 (2). Also AGA, s. 3 (2) specifically notes “An adult's way of communicating with others is not grounds for deciding that he or she is incapable of making decisions about [the adult's personal care, health care and financial affairs]. | ||
#HCCCFAA, s.8. | #HCCCFAA, s.8. | ||
#HCCCFAA, s.8 (a) and (b). | #HCCCFAA, s.8 (a) and (b). | ||
#O’Connor, D. (2009). Assessing incapacity: review of tools. Public Guardian and Trustee, page 10. Online : http://www.trustee.bc.ca/pdfs/STA/Incapability_Assessments_Review_Assessment_Screening_Tools.pdf Last accessed: | #O’Connor, D. (2009). Assessing incapacity: review of tools. Public Guardian and Trustee, page 10. Online: http://www.trustee.bc.ca/pdfs/STA/Incapability_Assessments_Review_Assessment_Screening_Tools.pdf (Last accessed: January 9, 2016)[“O’Connor”]. O’Connor notes that unlike some jurisdictions, the notion of ‘appreciation’ is not actually used in BC’s health care consent law. However, the ideas underpinning it are arguably captured in the standard that the person recognizes that the information applies to him or her. | ||
#O’Connor, p. 10 | #O’Connor, p. 10 | ||
#O Connor, p. 10. | #O Connor, p. 10. | ||
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#O’Connor, p. 25. | #O’Connor, p. 25. | ||
#O’Connor, p. 9. | #O’Connor, p. 9. | ||
{{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | {{REVIEWED | reviewer = BC Centre for Elder Advocacy and Support, June 2014}} | ||
{{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | {{Legal Issues in Residential Care: An Advocate's Manual Navbox}} | ||
