3.1 ‘Rules’ for supporting and assessing
The so-called ‘rules for assessing mental capacity’ are summarised here:
- Start by thinking I can make a decision.
- Do all you can to help me make a decision.
- You must not say I lack capacity just because my decisions seem unwise.
- Use a best interest checklist for me if I can't make a decision.
- Check the decision does not stop my freedom more than needed.
Activity 4 What does all this mean in practice?
You will have perhaps noticed as you have learned about mental capacity, decision making and now the assessment of capacity that there are a number of issues that affect each stage. What do you notice about the rules provided above? Take a second look at these and, thinking about what you have learned so far make a note of three key things that occur to you.
Provide your issues in the following table:
| Key issue one | Key issue two | Key issue three |
When you have recorded your three issues, think about what this means when you need to deal with someone who lacks mental capacity and who may need your help in decision making.
There is one example provided in the table. Try to fill in two more.
| Possible issue | What does this mean in practice? |
| Putting the person at the centre | Always remember to put the person first. The issue relates to and is about the individual. |
Comment
A range of issues need to be taken into account at all stages of assessing and supporting someone who may lack mental capacity. These include:
- All adults are presumed to be able to make their own decisions unless they are judged as lacking the mental capacity to do so.
- Ensure that the primary consideration is that unless you can prove otherwise, the person can, with help, make their own decision.
- Try to understand what the person’s preferences may be.
- Use language, other forms of communication and information that help the person understand the decision they are making and the risks and benefits of different outcomes.
- Try to put aside your own thoughts and feelings. If a person is making an unwise decision this does not mean that they lack capacity.