Many Care Managers and Social Workers are concerned about the future care needs of people with Learning Disabilities and Dementia as the move towards supported living gains momentum. Many often question whether it's the best option for people with Learning Disabilities and Dementia. As local authorities continue to tighten their belts around funding for residential care placements, care managers are often left with little or no options but to place clients in supported living settings.
The dilemma often faced by Care Managers and Social Workers is whether or not they have made the right decision about the long term care needs of their clients. They are often unclear of the process of assessing for capacity.
With the introduction of the Mental Capacity Act in 2007, help is at hand for those who still remain unsure as to whether or not their client with Learning Disabilities and possibly dementia has the capacity to understand the implications of the tenancy agreement of their supported living arrangements .
The Mental Capacity Act aims to support adults with impaired capacity so they can make decisions for themselves wherever possible. Where they can not make decisions, the act provides a framework for those who have to make and implement decisions. So in situations whereby it has been determined that the client lacks the capacity to make decisions about their long term needs, the act allows the care manager to make the decisions in the person's best interests. To arrive at a decision to act in the person's best interests the care manager must consider the following issues:
o Does the decision embrace the concept of person-centred care?
o Have family been consulted about best interests?
o Is there an Advanced Decision?
o Is there a need to involve an advocate?
o Has the client's past history been fully evaluated?
Clearly, making decisions about the long term care needs of people with Learning Disabilities is very complex indeed given the fact that many will develop dementia by the ages 40-50.
It is there that important that Care Managers and Social Workers have regular training and updates in the use of the Mental Capacity Act as well as keeping abreast of new developments in the area of Dementia in Learning Disabilities.