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People have the right to be involved in discussions and make informed decisions about their care, as described in your care. Making decisions using NICE guidelines explains how we use words to show the strength or certainty of our recommendations, and has information about professional guidelines, standards and laws including on consent and mental capacity , and safeguarding. Where appropriate, training should be interdisciplinary, involve experts by experience and include:. As a starting point they must assume capacity unless there is evidence to suggest an assessment is required.

This information should be used to inform advance planning, supported decision-making and best interests decision-making. Independent Mental Capacity Advocates to have expertise in specific areas that require additional skills and knowledge — for example working with people with impaired executive function arising from acquired brain injury, mental illness, dementia or other illness.

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Supporting decision-making capacity effectively requires a collaborative and trusting relationship between the practitioner and the person. It does not involve trying to persuade or coerce a person into making a particular decision, and must be conducted in a non-discriminatory way.

I. INTRODUCTION

It requires practitioners to understand what is involved in a particular decision, and to understand what aspects of decision-making a person may need support with, and why. This may mean helping a person with their memory or communication, helping them understand and weigh up the information relevant to a decision, or helping to reduce their distress. If they would like someone to support them, find out from the person who needs support who this should be. Be aware of the possibility that the nominated person may be exercising undue influence, duress or coercion regarding the decision, and take advice from a safeguarding lead if there is a concern.

These should include:.


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They should use this knowledge to develop a shared and personalised understanding of the factors that may help or hinder a person's decision-making, which can be used to identify ways in which the person's decision-making can be supported. This will depend on the nature and complexity of the decision itself. This should be about the process and principles of supported decision-making as well as about the specific decision. Give the person an opportunity to review and comment on what is recorded and write down their views. If there are no significant trusted people, or no-one willing to take on this role, think about involving an advocate.

The benefits could include increased autonomy, being better informed and sharing decisions with people interested in their welfare. However, practitioners should also be aware that talking about potentially upsetting issues including declining health or end of life can be potentially distressing, and a person may feel overwhelmed with having to make a difficult decision at a difficult time and having to deal with possibly conflicting opinions.

This is especially important:. Share the record with the person and, with their consent , other appropriate people. Advance care planning involves helping people to plan for their future care and support needs, including medical treatment, and therefore to exercise their personal autonomy as far as possible. This should be offered to everyone who is at risk of losing capacity for example through progressive illness , as well as those who have fluctuating capacity for example through mental illness.

Some approaches involve the production of legally binding advance decisions , which only cover decisions to refuse medical treatment, or the appointment of an attorney. Others, such as joint crisis planning and advance statements, which can include any information a person considers important to their health and care, do not have legal force, but practitioners must consider them carefully when future decisions are being made, and need to be able to justify not adhering to them. People can initiate advance care planning such as advance statements independently, without the input of practitioners.

Skilled practitioners need to be able to have sensitive conversations with people in the context of a trusting and collaborative relationship, and provide the person with clear and accessible information to help them make these important decisions. If the person wishes to engage in advance care planning, enable them to do so. It is the practitioner's responsibility to identify what information they need.


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  • They should:. In addition:. It may include who the person wants to have involved in decision-making or their preferences for issues such as treatment, support or accommodation.

    best interest in a sentence | Sentence examples by Cambridge Dictionary

    The offer should be documented and, if the person accepts it, the plan should be recorded. The inability to make a decision must not be due to other factors, for example because of undue influence, coercion or pressure, or feeling overwhelmed by the suddenness and seriousness of a decision.

    A lack of capacity cannot be established based merely by reference to the person's condition or behaviour. It can only be established if their condition also prevents them from understanding or retaining information about the decision, using or weighing it, or communicating their decision. It cannot be established unless everything practicable has been done to support the person to have capacity, and it should never be based on the perceived wisdom of the decision the person wishes to make.

    Effective assessments are thorough, proportionate to the complexity, importance and urgency of the decision, and performed in the context of a trusting and collaborative relationship. For example, this may include the individual's family or friends. If the assessment concludes that a person would, with appropriate support, have capacity to make their own decisions, the assessment should establish which elements of the decision-making process the person requires assistance with, in order to identify how decision-making can be supported.

    Best interests

    This may include involving an interpreter, speech and language therapist, someone with sensory or specialist communication skills, clinical psychologists or other professionals to support communication during an assessment of capacity. Structured assessments of capacity for individuals in this group for example, by way of interview may therefore need to be supplemented by real-world observation of the person's functioning and decision-making ability in order to provide the assessor with a complete picture of an individual's decision-making ability.

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    最佳利益第五集-Best Interest EP05(天心、鍾承翰、溫昇豪領銜主演)

    In the Child's Best Interests. Main content. Listen now. Show more. Available now 37 minutes. Last on. Sun 9 Dec BBC Radio 4. Notify me of followup comments via email. You can also subscribe to this post without commenting. By clicking Subscribe, you agree that we may send you regular information bulletins by email. You can unsubscribe at any time using the link in our emails. Go to the shop. We came across a bizarre situation recently which we wanted to share with you.

    However, the decision-maker has the ultimate power for decision making. Numerous attempts were made to contact the care home to discuss the matter, but without success. Share this article:. Mr Mark R Haynes 8 months ago Reply. Jenny 8 months ago Reply.