Wednesday, 3 February 2010

What can you do?

I was at work the other day, doing A&E support work.

One of the patients we went to was an elderly gentleman with alzheimers. I can't remember what was his presenting compliant was, except that it meant he needed to go into hospital. Problem was, he really didn't want to.

In this situation, we have to determine whether this person has capacity to refuse.

Are they capable of understanding information?
Are they capable of retaining information?
Are they capable of weighing up the information available to them, and making an informed decision?

Unfortunately, the answer to all of these questions was "no", however he was adamant that he was not coming with us, and wanted to stay in his chair.

Taking over 2 hours on scene, we eventually bullied this little old man into coming with us, but this was only due to being lucky enough to be able to seize the one moment out of the entire two hours where he relented for a moment.

So I have some questions for you, dear reader (if there's anyone out there still reading)

1. How long are you willing to stay on scene in a situation like this?
2. What options are available to you if the patient continues to refuse?
3. There is someone there with Power of Attorney over the patient. How does this affect your thinking?

Now I know that there are powers available to various people under the Mental Health Act - the patient can be sectioned, but I'm fairly sure that the patient wasn't eligible for any of these.

Oh, and (surprise, surprise) it was after opening hours for her GP surgery

1 comment:

  1. I'd you're talking about us (ie the police) sectioning someone under the mental health act, then sorry - the power is only allowed in a public place!

    This sometimes leads to some "creative" thinking to get someone to hospital so they can get the care they need.

    The LAS have powers under the mental capacity act to take people to hospital though, although I don't know if that's simply for paramedics or whether anyone wearing the green can.