Staff Perceptions and Capability in using the Mental Capacity Act to Assess Decision Making in those with Acquired Brain Injury and Executive Dysfunction. (13th April 2022)

• Record Type: Journal Article
• Authors: Cameron, Emma; Codling, James; Nash, Maxine
• Is Part Of: British journal of social work. Volume 52:Number 7(2022)
• Page Start: 3820
• Page End: 3839
• Publication Date: 2022-04-13
• Subjects: brain injury -- executive function -- frontal lobe paradox -- health professionals -- Mental Capacity Act -- social care professionals; Social service -- Periodicals; Social workers -- Periodicals; 361
• DOI: 10.1093/bjsw/bcac057
• Languages: English
• ISSNs: 0045-3102

Abstract

Abstract: The purpose of this article is to establish the perceptions and capability of social care professionals (SCPs) in using the Mental Capacity Act (MCA) 2005 to assess decision-making capacity in those who have executive dysfunction and issues pertaining to the frontal lobe paradox, in comparison to health care professionals (HCPs). HCPs and SCPs from inpatient and community neurorehabilitation teams, social care teams and a best interest assessor team were contacted via convenience sampling and participated in semi-structured interviews. Data from these consultations were analysed using a form of thematic analysis known as template analysis. Four over-arching template themes were identified: 'assessment structure', 'implications of brain injury', 'professionals' capability/expertise' and 'consent, self-report and mental capacity'. The findings suggest that SCPs would benefit from bespoke practice guidance designed to help with the application of the MCA with the acquired brain injury/long-term neurological conditions population—particularly where there is a concern about a person's ability to understand, apply or use information outside of an assessment or supportive conversation. Abstract : The Mental Capacity Act (MCA) 2005 provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make particular decisions for themselves. It should be referred to when assessing individuals' decision-making abilities. Assessing decision making in individuals with an acquired brain injury (ABI) can be more complex if executive dysfunction is present. Executive dysfunction is an umbrella term for difficulty with a wide range of cognitive skills, including insight, attention, planning, organisation, initiation, ideas generation, inhibition, control of behaviours and emotions, problem-solving, evaluation, judgement and decision making. Health and social care teams were interviewed about how they might approach MCA assessments with individuals who have an ABI. Findings suggested that SCPs in particular had difficulty understanding executive dysfunction, how this would impact on MCA assessments and how they needed to adapt their practice as a result. The authors suggest that SCPs in particular would therefore benefit from bespoke practice guidance to help with the application of the MCA in this area.