Navigating Complexities: A Case Study in Mental Capacity Assessment

Socialscape mental capacity assessment blog

Recently, I found myself involved in a Deprivation of Liberty (DoLS) assessment for an 80--year-old woman diagnosed with dementia, residing in a care home with restricted access. The crux of the matter lay in her fluctuating mental capacity, a challenge that required careful consideration.

During the assessment, it became evident that the woman was at her cognitive best during the day, with a decline in awareness as evening approached, becoming more disorientated. This led to attempts to leave the care home, forgetting the safety concerns explained by staff. The Mental Capacity Act, 2005 emphasizes assessing capacity at a person's best time, aligning with the principle of involving individuals in decision-making as much as possible.

After a thorough evaluation, it was clear that she possessed the capacity to understand and make decisions about her care home accommodation. Despite her awareness of the risks associated with her condition, she expressed contentment with her living situation. Notably, she acknowledged her struggles with self-care at home before moving to the care home, demonstrating insight into needs.

While DoLS wasn't applicable, I recommended revising her care plan to address capacity fluctuations and encouraging more community outings. Regrettably, the care home's response was less than receptive. They favored the convenience of a DoLS, providing a legal framework for restrictions, rather than accomodating her needs and wishes.

This scenario underscores a crucial point: professionals should prioritize the rights and well-being of clients over procedural ease. Educating the care home staff about vulnerable individuals' rights under the Mental Capacity Act was pivotal in shifting their perspective. It became evident that accommodating the lady's desire to occasionally leave the care home, with proper support, could enhance her emotional and potentially physical well-being.

In conclusion, our duty as professionals is to listen to the needs and desires of those we serve, even if it means extra effort on our part. Balancing risk management with individual autonomy is crucial, promoting not only the client's well-being but also fostering a culture of compassionate and person-centered care.