Adults with Incapacity

Question 1

What does incapacity mean?

Answer 1

Incapable means incapable of:
- acting
- making a decision
- communicating a decision
- understanding a decision
- retaining memory of the decision
in relation to any particular matter due to mental disorder or an inability to communicate
AMCUR

Question 2

How do you check a patient has understood and has the capacity to consent?

Answer 2

• open questions
• chunk and check
• teach back
  Do not ask do you understand or can you repeat back to me
• avoid assumptions, allow time and document patients understanding

Question 3

Which act applied if a person lacks capacity to consent to dental treatment?

Answer 3

Adults with Incapacity (Scotland) Act 2000
- safeguards the welfare and manages the finances of people aged 16 years and over who lack capacity

Question 4

If a person lacks capacity to consent to dental treatment, which certificate should be issued according to what 5 principles?

Answer 4

Section 47 certificate:
- benefit
- least restrictive of freedom
- the persons past and present wishes should be taken into account
- consult relevant others
- encourage residual capacity

Question 5

What is a proxy?

Answer 5

• someone who has been authorised to act on behalf of an adult with incapacity
• substitute decision maker
• legally recognised

Question 6

What are powers of attorney?

Answer 6

• granted by the adult whilst they have capacity to choose who they wish to act on their behalf, should the need arise
• must be in writing
• must be registered with the OPG
• powers are dormant until needed
• do not have an expiry date

Question 7

What are they types of powers of attorney?

Answer 7

Welfare = healthcare only
Continuing = finances/estates only
Joint or combined = health and finance/estates

Question 8

When checking the documents for a power of attorney what must you do?

Answer 8

• ask to see original copy or lawyer endorsed, electronic do not have embossed seal
• read the body of the document
  ‘‘The power to consent or withhold consent to medical and dental treatment’’
• must check what powers have been granted
• can check with OPG (Office of the Public Guardian)

Question 9

What is a guardian?

Answer 9

Granted when an adult either:
- no longer has capacity to choose who they wish to make decisions for them OR
- the adult has never been able to make their own decisions

Question 10

How does a person get a guardian? What are they types of guardianship?

Answer 10

• court process granted by a sheriff
• requires medical and social work report
• must be registered with the OPG
• continuous powers
• has an expiry date
  Types of guardianship: financial/property, welfare or both

Question 11

Who can consent for dental treatment?

Answer 11

• patients with capacity
• welfare power of attorneys
• welfare guardians with the appropriate powers
• medical and dental practitioners can authorise treatment under section 47 of AWI act - must be a dentist to authorise dental treatment