Summary
The National Institute for Health and Care Excellence (NICE) has released a guideline covering decision-making in adults, over 16 years of age, who may lack capacity. The aim to support people to exercise their own decision-making where they have the capacity, and to keep people who lack such capacity at the centre of decision-making. All fine and dandy.
Reference
Decision-making and mental capacity. NICE Guideline [NG108]. London: National Institute for Health and Care Excellence (NICE), October 2018.
There is a much longer version of the full guideline. There is also supporting evidence.
There is an associated online NICE Pathways version.
Involvement of Patients With Dementia in Decisions to Initiate Pharmacological Treatments?
A recent study of actual practice in memory clinics found that patients are initially the “nominated” decision-makers when advised to start medication for dementia, but that over 80% of patients tend to be reluctant to comply (usually through passive resistance) and yet their medications tend to be prescribed regardless.
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Reference
Dooley, J. Bass, N. [and] Livingston, G. [et al] (2018). Involving patients with dementia in decisions to initiate treatment: effect on patient acceptance, satisfaction and medication prescription. British Journal of Psychiatry. October 1st 2018: 1-5. [Epub ahead of print].
