Dementia and the Mental Capacity Act

Sam Cox

Knowledge Officer (Legal and Welfare Rights)

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

The MCA is one of the most important pieces of law for people

with dementia

Case studies

Highlighting the need for the MCA for people affected by dementia

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

Judith

• Not sure what to do

• When do I make decisions?

• When don’t I?

• 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 also…

• Provides guidance to professionals

• Places responsibilities on professionals

The MCA is not just important to professionals but to everyone…

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