This free course describes the principles and criteria underpinning the assessment of mental capacity and decision making in the UK. The course begins by looking at what mental capacity – and the lack of it – means. You will be introduced to various groups of people who are more likely to lack mental capacity, but you will also learn why it is relevant to everyone. You will look at what can be done to help someone to make a decision themselves and the principles and steps that enable people to judge, fairly, whether someone has capacity or not. You will be introduced to the legislation in the UK and will see how it supports and protects people who may lack capacity. [First Published: 15/12/2016; Updated: 20/01/2020].

Findings from a study to gather information from people who have experienced Do Not Attempt Resuscitation (DNAR) decision making, both since and prior to the Coronavirus pandemic. The report shows a worrying picture around the rights of involvement in care and treatment decisions, including DNARs. The evidence depicts serious issues of discrimination related to disability and age, and the intersection between the two, as well as other factors. Coronavirus has shone a spotlight on this, and some reported an increase in worrying DNAR decisions; but none of this is new, these problems are ongoing. The report’s key findings are: 100% of people involved said there needs to be more easily accessible information about human rights; almost 60% of people involved said they had received no information about their right to life during Coronavirus; 65% of people involved said that they (or a person they care for/about) had a DNAR order put on your medical file. 21% said they didn’t know; of those who had seen a DNAR order put in place almost half (47%) were not related to end-of-life care; less than a third of people (29%) who were involved in DNAR decision-making felt fully listened to, most felt listened to a bit (46%), and 25% felt not listened to; 91% of people involved felt that discrimination was an issue in the DNAR decisions they’d experienced.

With a growing global ageing population, approaches to assess and support decision-making are becoming more pertinent. This scoping review aimed to identify and map current knowledge on assessment of older adults’ decision-making capacity in relation to independent living. A five-stage scoping review framework was followed. Inclusion criteria were papers on assessment approaches used to evaluate decision-making capacity of older adults, aged 60 years and over for independent living, including studies involving people with cognitive impairment and dementia. Five databases were searched for publications with eligibility criteria from January 2000 to December 2020; 4,118 results were retrieved from sources, resulting in 29 publications being analysed, eight of which were research reports. Publication characteristics and methodologies varied; however, many common components of decision-making capacity assessment for independent living were identified including cognitive, functional, environmental and risk assessment. Overall, a multidisciplinary approach was recommended, and consideration of the person’s values and preferences is noted in many publications. Decision-making capacity assessment for independent living of older adults requires multicomponent, multidisciplinary assessment. Future work is needed to examine this from the perspective of older adults and their caregivers.

A brief introduction to lasting power of attorney, how to use it and what it involves.

Five test cases involving elderly people (RD, JB, JP, EP and JW) who suffered from a form of dementia were identified to enable the court to consider the question of when an application should be made to court under section 21A MCA. All five individuals were being deprived of their liberty in a care home or hospital setting under a DOLS authorisation. The court gave general guidance as to the approach that should be adopted by RPRs and IMCAs in deciding whether to issue proceedings under s.21A.