Mental Capacity Case Study
The district nurse knew that Sara had the right to accept or refuse treatment. According to the Mental Capacity Act (section 1, MCA) (2005) a presumption of capacity of a patient should not be made based on their medical condition, unless it's been proven otherwise because every adult has the right to make their own decisions. It is important that an individual rights are protected, if their grounds to believe that the individual lack capacity through illness (Leathard and McLaren, 2007). The district nurse had to establish whether Sara although mentally impaired, can give consent to refusal of treatment. To assess the patient capacity the district nurse performs the MMSE to establish capacity, with the help of the support worker to translate.
The MMSE is used to help estimate the severity progression of cognitive impairment (Alzheimer Society, 2016). The MMSE assessment deemed that Sara was unable to give consent. With evidence the MDT were now able to care for Sara under the guidance of the MCA 2005. The MCA (2005) specifies that if has been identified that the patent lacks capacity, the decision made must be done in the best interests of the individual.
Since Sara was unable to consent for herself it was up to the district nurse to act as an advocate for the patient by consenting via proxy. Advocating is an important role identified by the NMC code when a patient lacks capacity. The code states: act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care (NMC, 2015 section 3.4). Hendrick (2004) acknowledge that an advocate responsibility is to exercise their rights to act autonomously. However, Ellis (2015) believes that advocating does not empower patient, instead it take power away from the patient. The MDT upholds the Human Right Act within Sara care. According to the Human Rights Act (HRA) (1998) no one should be deprived of their right to liberty and subjected to inhumane or degrading treatment. All action carried out by the MDT were in the best interest of the patient.
The MMSE is used to help estimate the severity progression of cognitive impairment (Alzheimer Society, 2016). The MMSE assessment deemed that Sara was unable to give consent. With evidence the MDT were now able to care for Sara under the guidance of the MCA 2005. The MCA (2005) specifies that if has been identified that the patent lacks capacity, the decision made must be done in the best interests of the individual.
Since Sara was unable to consent for herself it was up to the district nurse to act as an advocate for the patient by consenting via proxy. Advocating is an important role identified by the NMC code when a patient lacks capacity. The code states: act as an advocate for the vulnerable, challenging poor practice and discriminatory attitudes and behaviour relating to their care (NMC, 2015 section 3.4). Hendrick (2004) acknowledge that an advocate responsibility is to exercise their rights to act autonomously. However, Ellis (2015) believes that advocating does not empower patient, instead it take power away from the patient. The MDT upholds the Human Right Act within Sara care. According to the Human Rights Act (HRA) (1998) no one should be deprived of their right to liberty and subjected to inhumane or degrading treatment. All action carried out by the MDT were in the best interest of the patient.