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teaching:on-mha:f-ltc-capacity [2019/03/14 00:38]
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teaching:on-mha:f-ltc-capacity [2020/04/30 22:17] (current)
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 ====== Long-Term Care Capacity Assessment ====== ====== Long-Term Care Capacity Assessment ======
 +{{INLINETOC}}
 ===== Primer ==== ===== Primer ====
 In Ontario, the law requires the consent of a patient before admission to a care facility such as a long-term care (LTC) home. However, one may not recognize his or her need for placement into a long-term care home, even when this placement is important to their health. Cognitive impairment or dementia, may cause a decline in memory, reasoning, planning and judgement, and make one incapable to decide if they need LTC. Thus, if incapacity is suspected, the patient’s capacity for consent for LTC needs to be assessed. ​ In Ontario, the law requires the consent of a patient before admission to a care facility such as a long-term care (LTC) home. However, one may not recognize his or her need for placement into a long-term care home, even when this placement is important to their health. Cognitive impairment or dementia, may cause a decline in memory, reasoning, planning and judgement, and make one incapable to decide if they need LTC. Thus, if incapacity is suspected, the patient’s capacity for consent for LTC needs to be assessed. ​
  
 ==== Documentation ==== ==== Documentation ====
-<code+<panel type="​info"​ title="​Sample Documentation for Capacity Assessment"​ no-body="​true"​ icon="​fa fa-pencil"​
-Over course of assessments ​last week and today, patient is CAPABLE/​INCAPABLE to make an admission decision.+Over course of assessments ​from [DATE(S)], patient is [CAPABLE/​INCAPABLEto make an admission decision.
  
-MMSE or MOCA scores ​(Moca on admission ##)hasno insight into her cognitive limitations. Due to the mental health condition, patient is able/unable ​to understand information presented to the patient. Patient ​does not/have currently have the ability to retain information and convey this back to demonstrate ​she has understood.+Patient has [MMSE/MOCA scores]and [HAS/DOES NOT HAVE] insight into their cognitive limitations. Due to [DIAGNOSIS], patient is [ABLE/UNABLE] ​to understand information presented to them. Patient ​currently [HAS/DOES NOT HAVE] the ability to retain information and convey this back to demonstrate ​that they have understood.
  
-When discussing the topics of staying at home versus moving to a long term care facility, ​Pt is ABLE/UNABLE to answer questions regarding consequences of staying at home VS going to long term care. When the patient was asked about what problems ​pt is currently having, pt denied/admitted ​to all concerns. Specifically questioned about insight into cognitive abilities, replied " "on repeated occasions.+When discussing the topics of staying at home versus moving to a long term care facility, ​patient ​is [ABLE/UNABLEto answer questions regarding consequences of staying at home versus ​going to long term care. When the patient was asked about what problems ​they are currently having, pt [DENIED/ADMITTED] ​to all concerns. Specifically questioned about insight into cognitive abilities, replied ​[" "on repeated occasions.
  
-It is evident that patient DOES/DOES NOT understand the extent of cognitive deficits, or how these are affecting safety. When asked about admission to a nursing home to help with any problems, Patient WAS/WAS NOT able to discuss this rationally. It is evident that patient is ABLE/UNABLE to appreciate any consequences of living independently versus in a nursing home. Regarding other ways to look after one's condition, patient DOES/DOES NOT feel that the cognitive problems interfere with function. When questioned regarding what would happen if patient indeed chose to move into a nursing home, responded "____".+It is evident that the patient ​[DOES/DOES NOTunderstand the extent of their cognitive deficits, ​and/or how these deficits ​are affecting ​their safety. When asked about admission to a nursing home to help with any problems, Patient ​[WAS/WAS NOTable to discuss this rationally. It is evident that patient is [ABLE/UNABLEto appreciate any consequences of living independently versus in a nursing home. Regarding other ways to look after one's condition, patient ​[DOES/DOES NOTfeel that the cognitive problems interfere with function. When questioned regarding what would happen if patient indeed chose to move into a nursing home, they responded ​[" "].
  
-Patient is deemed CAPABLE/​INCAPABLE to make decisions regarding admission to long term care. The appropriate ​CCAC forms were completed, and the patient was given the rights information sheet. This sheet was explained in detail, should the patient wish to appeal this finding. Patient DID/DID NOT indicate an intent to appeal this. +Patient is deemed ​[CAPABLE/​INCAPABLEto make decisions regarding admission to long term care. [IF INCAPABLE: ​The appropriate forms were completed, and the patient was given the rights information sheet. This sheet was explained in detail, should the patient wish to appeal this finding. Patient ​[DID/DID NOTindicate an intent to appeal this.] 
-</code>+</panel>
  
 ===== Pearls ===== ===== Pearls =====