‘More of a leg to stand on’: Views and usage of the Mental Capacity Act 2005 among staff of local Alzheimer's Society and carer organisations

Abstract

Objectives: The Mental Capacity Act (MCA) 2005 was implemented in 2007 in England and Wales. It offers new opportunities for people to plan for any future loss of capacity and provides a framework for decision-making on behalf of people lacking capacity. This article explores the challenges staff in local voluntary organisations focusing on dementia and carers face when they offer information and advice connected to possible loss of decision-making capacity to people with dementia and carers.

Method: A set of 17 qualitative interviews were undertaken with a purposively sampled voluntary sector staff in London in 2008–09. Framework analysis was used to delineate themes in the transcripts and identified themes were included in the iteratively developed coding framework

Results: Interviews revealed that voluntary sector staff generally perceived the Act as largely benefiting people with dementia in the exercise of their rights. They also thought that carers would benefit from the Act's provisions, whilst their own involvement in advice, information-giving and referral to other sources of expertise in relation to the MCA differed according to their role and confidence. Voluntary sector staff's capability and interest in using the MCA vary; there should be no presumption of detailed knowledge, and resources relevant to the MCA might be need to be coordinated more effectively by this sector.

Conclusion: Ongoing training, local coordination and auditing seem warranted. These could encompass the new safeguarding provisions of the MCA which may need to be highlighted as part of the welcome extension of rights conferred by the MCA.

Keywords:

• mental capacity
• dementia
• carers
• planning
• decision-making

Acknowledgements and disclaimer

We are grateful to all participants for sharing their views with us. This article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1005). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. The research forms part of the EVIDEM programme of research (www.evidem.org.uk) (Evidence-based Interventions in Dementia).