The concept of mental capacity is crucial to the process of decision-making, whereby a decision may lack enforceability when there is an obvious reason to believe that the maker lacks the requisite mental capacity. Suffice to note from the onset; capacity may be limited by multiple factors such as age, which affect the state of mind. Spells of lucidity equally affect the integrity of the mental capacity to make a decision. Bearing in mind the foregoing, the paper undertakes an assessment of the mental capacity of Mrs. Brown, with particular reference to the unique set of circumstances which seek to transfer her to a rehabilitation home for the aged, and thus the crucial question becomes as to whether she perhaps lacks a capacity to self-determine on this crucial aspect.
The operational principle that regulates the domain of capacity is the Mental Capacity Act, as complemented with the standard regulation and codes of conduct that are envisaged under the Health and Care Profession Council (HCPC). The scope of the act is nevertheless limited, wherein the Mental Capacity Act, 2005 stipulates that its application is in the regulation of older adults with advanced dementia and lack the capacity to make decisions (Ng 2015, p.646).
Invariably, the principle of assumption is integral in the assessment of mental health, and thus the assumption by law and regulation is that the persona is at all times presumed to have the mental capacity to make a decision unless this is proved otherwise. Thus, the analysis of Mrs. Brown’s case is interpreted that she has the capacity to make a decision unless it is proved otherwise. The evidence of loss of capacity is arrived at from professional opinion as well as by inference of behavior of the subject (Cave 12015, p.88).
Furthermore, the law, as well as the underpinning principles on capacity that are contained in the principles of professional ethics, indicate that the person does not lose mental capacity unless it is demonstrated that reasonable steps have been initiated to help them overcome any hurdles to their mental state. Hence, in assessing the case at hand, the facts and circumstances become material in determining whether any form of help was offered to Mrs. Brown. The position herein is that there is a stark lack of any steps that indicate that there was a conscious effort to help Mrs. Brown in the decision-making process that culminated in her admission in rehabilitative care. In fact, persuasive analysis of the facts indicates that she is unduly influenced into care on the pedestal that her family, in this case, her daughter, is unavailable to help in her care.
Furthermore, by prescription of the law as well as sound practice, the best interest of the older adult must be maintained. In this case study, Mrs. Brown’s best interest is material to the decision of whether she should be admitted to old age care or not. This aspect applies only when it is provable that capacity has been lost. On this ground, the position herein remains that Mrs. Brown has the mental capacity to make the decision, whereby if it is alleged that sending her to home care was in her best interest, then it is a premature decision. This is because she has not lost her mental capacity for decision making and, in fact, is not agreeable to it, and this would then amount to frustrating her. Thus it is against her best interest of serenity of mind. Nevertheless, it is important to point out that an unwise decision does not qualify to rob a person of decision-making ability (Moriarty 2012, p.75). The position is that if Mrs. Brown deems it unwise to go to a home care center, this is not a sufficient ground for holding that she lacks the mental capacity to decide.
The professional council guidelines also apply wherein the conduct of the physiotherapist is relevant. As per the council’s code of conduct, practitioners should strive to know the limits of their practice. This means that all health professionals are under an obligation to act within the boundaries and scope of their professional duty. Arguably, the paper’s position is that the physiotherapist acted ultra vires, which is beyond the scope of the required opinion by suggesting to the family that Mrs. Brown should be admitted to an old age care facility. By inference, it is an infringement of the autonomous assumption of capacity on the part of Mrs. Brown. In any case, as her personal physiotherapist, they are bound to embrace consultation in all of the stages of interaction with the patient. This conclusion hinges on standard 2 that regulates the physiotherapists’ ethical conduct and practice. It births an obligation to consult with the patient (HCPC 2020).
In respect of the responsibility of assessment of mental capacity, it is undertaken by a qualified professional and often is done by a social worker through interaction by the person. Upon the application of various standards, then it is appropriate to determine the capacity of the individual.
It is imperative to point out that every decision should rely on a multi-disciplinary assessment. Apart from the social worker, other professionals are brought in to weigh in on the conclusion made in respect of mental capacity. Cognizance is made to the fact that the physiotherapist’s opinion should not be trivialized, though it should not be the only opinion of assessment. Aptly is that it should be complemented with more specialized opinion. On this pedestal, despite Mrs. Brown’s moments of absenteeism in thought as is manifest in spells of confusion, the assessment should not be rushed. Besides, the family’s position and role cannot be underscored enough, and thus it is important that care and any incidental decision should be consultative. Despite the consultation requirement, the autonomy of a decision making still remains with the older adult. In any case, the assessment is unique and varies from one individual to another.
In conclusion, an older adult’s mental capacity should not be taken away by the mere fact of an accident or otherwise a lapse in judgment. The law is quick to protect this autonomy all the time unless it is necessary. Moreover, best interest persuasively postulates that she is better placed when with her family, and the accompanying expenses can in effect be catered for through the employment of a carer. In summation, therefore, Mrs. Brown should make her own decision without undue pressure, and if a mental assessment is necessary, it should be undertaken by a social worker or any other qualified professional.