Advance Statements Regarding the Future Care of Individuals

Advance statement

Under the Mental Capacity Act someone with mental capacity can make decisions about what they would like to happen in the event of them no longer having the mental capacity to make the decision. This is what is known as an advance statement.

Advance statements’ make sure that an individual’s wishes are taken into account in the future. This is often referred to as ‘advance care planning’. The purpose is to enable an individual to make choices and decisions about their future care and support in case there is a time when they are unable to make decisions for themselves, for example in the later stages of dementia. This ensures that an individual is not given care or treatment that they do not wish to receive but will receive the care they wish to have. The law requires that the individual’s past and present wishes and feelings are considered.

Advance Decision

An Advance Decision is “A decision to refuse specified treatment made in advance by a person who has capacity to do so. This decision will then apply at a future time when that person lacks capacity to consent to, or refuse, the specified treatment…” (MCA S.24 (i) MCA Code of Practice Chapter 9)

Specific rules apply to these advance decisions to refuse life sustaining treatment. (MCA section 4 (5)

An advance decision to refuse medical treatment should be put in writing. A copy of an advance decisions to refuse medical treatment should be lodged with the person’s GP.

Use to answer question 9.6d of the Care Certificate

When an assessment of capacity might need to be undertaken

An assessment of capacity might need to be undertaken when a person is unable to make a particular decision at a specific time. The Mental Capacity Act 2005 applies to supporting an individual to make both day to day decisions (for example what to eat) and complex choices such as around care and support or managing finances.

It is important to remember that an individual may lack the capacity to make a specific decision, such as around finances, but this does not mean that they lack capacity to make all decisions.

How can advance statements affect future care

An advance statement could relate to any aspect or a person’s health, wellbeing or social care. For example a person may make decisions for the future on how staff meet their personal care needs (whether the individual prefers a bath or a shower), the type of service an individual may prefer (a person may wish to be cared for at home rather than in a residential setting or hospice) and end of their life considerations (what a person might like to happen spiritually, culturally).

Use to answer question 9.6d of the Care Certificate

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